Most CRE infections happen in hospitals and long-term living facilities among older, immune compromised patients. Photo by Monkey Business Images/Shutterstock
CHICAGO, Oct. 20 (UPI) -- Children are increasingly being infected by carbapenem-resistant Enterobacteriaceae, or CRE, bacteria found at hospitals that is resistant to many types of antibiotics, according to new research.
CRE infection affects patients in hospitals and long-term care facilities, especially those whose care involves ventilators, urinary catheters, or intravenous catheters. According to the Centers for Disease Control and Prevention, about half of patients infected by CRE die.
In many of these patients, long-term treatment with antibiotics means the drugs are ineffective against infections such as CRE, limiting doctors' options for treating the infection.
While the increases in infection rates among children are concerning, there is a lack of research into the infections with children -- most cases are found in nursing homes and among the critically ill -- and the means by which the bacteria become resistant may be different.
"This difference would affect how the patients are treated and infections are best prevented," said Dr. Latania Logan, an assistant professor of pediatrics at Rush University Medical Center, in a press release. "We are looking at these differences currently so that we can figure out the best strategies for prevention."
Researchers reviewed 316,253 cultures obtained from children in the United States between 1999 and 2012 from 300 clinics participating in the The Surveillance Network–USA database. They found the rate of infection among children of all ages and settings increased from 0 percent in 1999 to 0.47 percent in 2012.
The researchers also found, among children ages 1 to 5, CRE presence in cultures from children in intensive care units increased from 0 percent to 4.5 percent, and CRE in bloodstream samples increased from 0 to 3.2 percent.
The methods by which adults are exposed to CRE, especially older adults, are understood, researchers wrote in the study, however prevalence in nursing homes and among people with compromised immune systems or long-term residence in medical facilities does not explain the increases among children.
Though the researchers note incidence among children remains low, the increases still must be considered.
"There have not previously been any nationwide studies assessing the prevalence and epidemiology of CRE in U.S. children, so to date no one has known whether CRE are a true emerging problem in children," Logan said.
The study is published in Emerging Infectious Diseases.