Volume 30, Number 6—June 2024
CME ACTIVITY - Research
Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020
Table 3
Characteristic |
CRE, 2016–2020 |
ESBL-E, 2019–2020† |
p value |
---|---|---|---|
Demographic | n = 159 | n = 207 | |
Sex | <0.01 | ||
F | 94 (59.1) | 165 (79.7) | |
M | 64 (40.3) | 41 (19.8) | |
Unknown | 1 (0.6) | 1 (0.5) | |
Age group, y | <0.01 | ||
Median, IQR | 5 (1–10) | 6 (2–15) | |
<1 | 35 (22.0) | 30 (14.5) | |
1–3 | 30 (18.9) | 40 (19.3) | |
4–9 | 47 (29.6) | 56 (27.1) | |
10–14 | 28 (17.6) | 27 (13.0) | |
15–17 | 19 (12.0) | 54 (26.1) | |
Race | 0.62 | ||
White | 79 (50.0) | 92 (44.4) | |
Black | 29 (18.2) | 25 (12.1) | |
Other | 14 (8.8) | 16 (7.7) | |
Unknown | 37 (23.3) | 74 (35.8) | |
Ethnicity | 0.89 |
||
Hispanic | 43 (27.0) | 45 (21.7) | |
Non-Hispanic | 86 (54.1) | 96 (46.4) | |
Unknown |
30 (18.9) |
66 (31.9) |
|
Clinical‡ | |||
Underlying conditions§ | n = 158 | n = 169 | |
Premature birth | 20 (12.7) | 11 (6.5) | 0.06 |
Diabetes mellitus | 0 | 2 (1.2) | 0.27 |
Neurologic condition, any | 34 (21.5) | 20 (11.8) | 0.02 |
Urinary tract problems/abnormalities | 42 (26.6) | 22 (13.0) | <0.01 |
Cardiovascular disease | 13 (8.2) | 3 (1.8) | <0.01 |
Chronic pulmonary disease | 25 (15.8) | 21 (12.4) | 0.38 |
Chronic renal disease | 24 (15.2) | 3 (1.8) | <0.01 |
Gastrointestinal disease | 3 (1.9) | 1 (0.6) | 0.23 |
Skin condition | 12 (7.6) | 8 (4.3) | 0.28 |
Malignancy (hematologic or solid organ) | 10 (6.3) | 2 (1.2) | <0.01 |
Transplant (hematopoietic stem cell or solid organ) | 15 (9.5) | 1 (0.6) | <0.01 |
None | 59 (37.3) | 110 (65.1) | <0.01 |
Any condition |
99 (62.7) |
59 (34.9) |
<0.01 |
Epidemiologic classification of incident cases | |||
Hospital onset | 40 (25.3) | 13 (7.7) | <0.01 |
Community-associated | 43 (27.2) | 109 (64.5) | <0.01 |
Healthcare-associated community onset | 68 (43.0) | 40 (23.7) | <0.01 |
Unknown | 7 (4.4) | 7 (4.1) | 0.90 |
*Values are no. (%) except as indicated. Fisher exact test used for comparative statistics when >20% of expected cell counts were <5. Boldface indicates p<0.05. CRE, carbapenem-resistant Enterobacterales; ESBL-E, extended-spectrum β-lactamase–producing Enterobacterales. †ESBL-E surveillance was completed for 6 months during 2019. ‡Clinical characteristics were available for cases with completed case report forms only. §Cases could have >1 underlying condition associated with culture. Underlying conditions are further defined as follows: premature birth, birth before the week 37 of pregnancy, selected if medical record indicated premature birth and patient was <2 y of age; diabetes mellitus, includes both type I and type II; neurologic condition, any, includes cerebral palsy, chronic cognitive deficits, epilepsy/seizure/seizure disorders, multiple sclerosis, neuropathy, and others; urinary tract problems/abnormalities, a structural or functional urinary tract abnormality leading to obstruction or retention of urine as documented in the medical record; cardiovascular disease, includes congenital heart disease, congestive heart failure, prior cerebrovascular accident/stroke, peripheral vascular disease; chronic pulmonary disease, includes cystic fibrosis and any chronic respiratory condition resulting in chronic symptomatic dyspnea in medical record; chronic renal disease, includes chronic kidney disease (all stages), end-stage renal disease with or without dialysis; gastrointestinal disease, includes inflammatory bowel disease, liver disease, peptic ulcer disease, and short gut syndrome; skin condition, includes pressure ulcers, surgical wounds, other skin conditions such as eczema, psoriasis; malignancy, includes hematologic, metastatic and nonmetastatic solid organ; transplant, includes hematopoietic stem cell and solid organ.