A Multicenter Evaluation of Gram-negative Bloodstream Infections in Children: Predictors of Carbapenem Resistance
Makaleler > Tam Makale · 2026
Yazarlar: Asli Arslan, Sema Yildirim Arslan, Zehra N. Coskun, Ergin Ciftci, Sevgen Tanir Basaranoglu, Sevgi Yasar Durmus, Merve Kiliç Çil, Gizem Guner Ozenen, Ozge Kaba, Mustafa Genceli, Elif Dede, Onur Tekeli, Ayse Cakil Guzin, Ummuhan Cay, Hacer Akturk, Hatice Sinav Utku, Semra Sen Bayturan, Merve Iseri Nepesov, Nezihe Bilge Bahçeci, Senem Behsat Ulukaya, Gülben Ozgul Postuk, Oznur Ege Akdi, Gizem Mardinoglu, Demet Tosun, Zümrüt ŞAHBUDAK BAL, on Behalf of the PED-CRE Turkish Study Group
Pediatric Infectious Disease Journal, Uluslararası, Wos, 2026
DOI: 10.1097/inf.0000000000005270
Özet
BACKGROUND: Pediatric carbapenem-resistant Gram-negative (CRGN) infections cause high morbidity and mortality. Despite the rising global threat, multicenter data on resistance drivers in children remain limited. This study aimed to determine the prevalence, carbapenem resistance (CR) rates and clinical risk factors for Gram-negative bloodstream infections (GNBSIs) among hospitalized children in Turkey. METHODS: A 1-month point prevalence study was conducted in November 2023 across 27 tertiary hospitals. Hospitalized patients (1 month-18 years) with laboratory-confirmed GNBSIs were included. Independent risk factors and prior antibiotic exposures were analyzed using regression models. RESULTS: Among 15,249 patients, 180 GNBSIs were identified (prevalence: 1.19%). K. pneumoniae (28.3%), E. coli (12.7%) and P. aeruginosa (11.5%) were the most frequent pathogens. The overall CR rate was 33.3%, peaking at 73.6% in A. baumannii. Independent risk factors for CRGN BSIs included university hospital setting [adjusted odds ratio (aOR): 3.05; 95% confidence interval (CI): 1.47-6.31], central venous catheterization (aOR: 3.23; 95% CI: 1.10-9.40), mechanical ventilation (aOR: 2.59; 95% CI: 1.18-5.63) and steroid use (aOR: 2.59; 95% CI: 1.10-6.04). Prolonged antibiotic exposure (>7 days) to meropenem, colistin, glycopeptides and aminoglycosides significantly increased the odds of CR ( P < 0.05). CONCLUSIONS: This study highlights a high burden of CR in pediatric GNBSIs in Turkey. The identification of modifiable risk factors and the high prevalence of multidrug-resistant isolates emphasize the urgent need for enhanced infection control and robust antimicrobial stewardship programs.