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Volume 30, Number 6—June 2024
CME ACTIVITY - Research

Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020

Heather N. GromeComments to Author , Julian E. Grass, Nadezhda Duffy, Sandra N. Bulens, Uzma Ansari, Davina Campbell, Joseph D. Lutgring, Amy S. Gargis, Thao Masters, Alyssa G. Kent, Susannah L. McKay, Gillian Smith, Lucy E. Wilson, Elisabeth Vaeth, Bailey Evenson, Ghinwa Dumyati, Rebecca Tsay, Erin Phipps, Kristina Flores, Christopher D. Wilson, Christopher A. Czaja, Helen Johnston, Sarah J. Janelle, Ruth Lynfield, Sean O’Malley, Paula Snippes Vagnone, Meghan Maloney, Joelle Nadle, and Alice Y. Guh
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (H.N. Grome, J.E. Grass, N. Duffy, S.N. Bulens, U. Ansari, D. Campbell, J.D. Lutgring, A.S. Gargis, T. Masters, A.G. Kent, S.L. McKay, A.Y. Guh); Foundation for Atlanta Veterans Education and Research, Decatur, Georgia, USA (G. Smith); Atlanta Veterans Affairs Medical Center, Decatur (G. Smith); Maryland Department of Health, Baltimore, Maryland, USA (L.E. Wilson, E. Vaeth, B. Evenson); New York Rochester Emerging Infections Program at the University of Rochester Medical Center, Rochester, New York, USA (G. Dumyati, R. Tsay); University of New Mexico, Albuquerque, New Mexico, USA (E. Phipps, K. Flores); New Mexico Emerging Infections Program, Santa Fe, New Mexico, USA (E. Phipps, K. Flores); Tennessee Department of Health, Nashville, Tennessee, USA (C.D. Wilson); Colorado Department of Public Health and Environment, Denver, Colorado, USA (C.A. Czaja, H. Johnston, S.J. Janelle); Minnesota Department of Health, St. Paul, Minnesota, USA (R. Lynfield, S. O’Malley, P. Snippes Vagnone); Connecticut Department of Public Health, Hartford, Connecticut, USA (M. Maloney); California Emerging Infections Program, Oakland, California, USA (J. Nadle)

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Table 2

Incident pediatric CRE and ESBL-E cases with annual crude incidence, by geographic regions and demographic characteristics, United States*

Category
 Crude annual incidence rate
Incident CRE cases
Incident ESBL-E cases
2016
 2017
 2018
 2019
 2020
 2019‡
 2020
EIP sites by geographic region†
Northeast 0.63 0.00 1.24 0.91 1.38 26.15 24.39
Midwest 1.25 0.74 0.25 0.99 0.99 NA NA
South 0.82 0.55 0.71 1.05 0.44 26.30 16.57
West 0.86 0.37 0.48 0.64 0.38 27.15 20.15
Total
 0.87
 0.47
 0.68
 0.87
 0.63
26.54
 19.63
Demographic characteristics
Sex§
M 0.44 0.32 0.75 0.67 0.52 13.04 6.28
F 1.26 0.62 0.61 1.07 0.74 39.89 33.43
Race
White 0.68 0.31 0.55 0.78 0.50 23.85 13.96
Black 0.57 0.32 0.57 1.05 0.38 12.79 5.92
Other¶ 0.41 0.26 0.35 0.24 0.56 20.26 12.29

*Crude annual incidence rate, cases/100,000 pediatric population. CRE, carbapenem-resistant Enterobacterales; EIP, Emerging Infections Program; ESBL-E, extended-spectrum β-lactamase–producing Enterobacterales; NA, not applicable. †EIP sites grouped according to the 4 geographic regions defined by the US Census Bureau because of small case counts at some sites. California did not participate in CRE surveillance in 2016. Connecticut did not participate in CRE surveillance in 2016 or 2017. California, Connecticut, Minnesota, and Oregon do not participate in ESBL-E surveillance. ‡ESBL-E surveillance was completed for 6 months during 2019. Crude annual incidence rates estimated as the number of cases multiplied by 2 divided by population based on 2019 US Census for that year. §One CRE and 1 ESBL-E case had sex reported as unknown. ¶Other represents all reported races not indicated as White or Black, including American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, or some other race. This combination category was necessary because of small numbers of pediatric cases in persons of races other than White or Black. In addition, 37 CRE cases and 74 ESBL-E cases had race indicated as unknown (not included in this category).

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Page created: April 24, 2024
Page updated: May 22, 2024
Page reviewed: May 22, 2024
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