{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:39:24Z","timestamp":1791470364503,"version":"4.3.4"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) infections among children represents a significant global concern, leading to elevated mortality rates. The aim of this study was to evaluate the risk factors, outcomes, 30-day mortality rates and contributing factors in children with CRE bloodstream infections (CRE-BSIs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data regarding demographic characteristics, treatment approaches and outcomes of hospitalized children aged 0\u201318\u2005years diagnosed with CRE-BSIs between January 2018 and December 2022 were extracted from medical records. Mortality within 30\u2005days of diagnosis and the predictive factors were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 114 children, with a median age of 11\u2005months (range: 6\u201369.5), were included. All cases of CRE-BSIs were either healthcare associated or hospital acquired and presented with at least one underlying comorbidity. A previous history of CRE colonization or infection rate was 48.2% (55\/114). Klebsiella pneumoniae 87.7% (100\/114) was the most frequently isolated microorganism, with a 30-day mortality rate of 14% (16\/114). Multivariate analysis identified paediatric intensive care unit admission, invasive mechanical ventilation, inotropic support and thrombocytopenia due to CRE-BSIs as the most discriminative predictors for 30-day mortality (P\u200a&amp;lt;\u200a0.001). Central venous catheter (CVC) removal was associated with a reduced mortality rate (P\u200a=\u200a0.012). High-dose prolonged infusion of MEM-based or polymyxin-based antibiotic combinations did not impact survival. Lower MEM MIC values were associated with improved survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The mortality rate of CRE-BSI is notably high in childhood. The use of antibiotic combination strategies did not demonstrate a significant impact on 30-day survival; however, the removal of CVCs was found to lower mortality rates.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae387","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T19:12:31Z","timestamp":1730315551000},"page":"147-153","source":"Crossref","is-referenced-by-count":9,"title":["Clinical outcomes and the impact of treatment modalities in children with carbapenem-resistant Enterobacteriaceae bloodstream infections: a retrospective cohort study from a tertiary university hospital"],"prefix":"10.1093","volume":"80","author":[{"given":"Gulhadiye","family":"Avcu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, Ege University , Izmir 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