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Volume 21, Number 11—November 2015
Research

Carbapenem-Resistant Enterobacteriaceae in Children, United States, 1999–2012

Latania K. LoganComments to Author , John P. Renschler, Sumanth Gandra, Robert A. Weinstein, Ramanan Laxminarayan, and for the Centers for Disease Control and Prevention Epicenters Program
Author affiliations: Rush University Medical Center, Chicago, Illinois, USA (L.K. Logan, R.A. Weinstein); John H. Stroger, Jr. Hospital of Cook County, Chicago (L.K. Logan, R.A. Weinstein); Center for Disease Dynamics, Economics and Policy, Washington, DC, USA (J.P. Renschler, S. Gandra, R. Laxminarayan); Public Health Foundation of India, New Delhi, India (R. Laxminarayan); Princeton University, Princeton, New Jersey, USA (R. Laxminarayan)

Main Article

Table 3

Co-resistance of 266 carbapenem-resistant Enterobacteriaceae isolates, The Surveillance Network–USA Database 1999–2012*

Drug class or drug No. nonsusceptible/no. tested (%)
Aminoglycosides 139/266 (52.26)
Gentamicin 108/265 (40.75)
Tobramycin 116/235 (49.36)
Amikacin 49/230 (21.30)
β-lactam/β-lactamase inhibitors 236/249 (94.78)
Ampicillin/sulbactam† 188/194 (96.91)
Piperacillin/tazobactam 201/231 (87.01)
Cefepime 125/241 (51.87)
Ciprofloxacin 122/253 (48.22)
Trimethoprim/sulfamethoxazole 142/263 (53.99)
Multidrug resistant‡ 127/263 (48.29)

*Rows showing drug classes (aminoglycosides, β-lactam/β-lactamase inhibitors) indicate number of isolates that were tested against >1 drug listed in the class and the number of isolates that were nonsusceptible to >1 drug listed in the class. Tigecycline susceptibility test results were not recorded in the database. Polymyxin B and colistin susceptibility test results were recorded in the database, but none of the carbapenem-resistant Enterobacteriaceae (CRE) isolates were tested against those drugs. Only 1 CRE-positive isolate was tested against fosfomycin. CRE is defined as resistance to all tested third-generation cephalosporins (ceftriaxone, cefotaxime, or ceftazidime), and nonsusceptiblity to >1 carbapenem (ertapenem, imipenem, meropenem, or doripenem). For bacteria with intrinsic imipenem nonsusceptibility (P. mirabilis), the CRE criteria required nonsusceptibility to >2 of the carbapenems listed.
Citrobacter (n = 8) and Enterobacter (n = 98) species are intrinsically resistant (22) to ampicillin/sulbactam. However, they have been included in the table.
‡These CRE isolates were nonsusceptible to >1 drug from each of the following 3 drug classes: aminoglycosides (gentamicin, tobramycin, amikacin), β-lactams (ampicillin/sulbactam, piperacillin/tazobactam), fluoroquinolones (ciprofloxacin), and trimethoprim/sulfamethoxazole.

Main Article

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Page created: October 29, 2015
Page updated: October 29, 2015
Page reviewed: October 29, 2015
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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