294 - Case-Control Study of Pediatric Patients with Carbapenem-Resistant Enterobacterales Blood Stream Infections at Texas Children’s Hospital from 2014-2019

Poster Number: 294
Publication Number: 294.114

Melissa Y. Kok, Baylor College of Medicine, Sugar Land, TX, United States; Debra Palazzi, Baylor College of Medicine, Houston, TX, United States

Background: Carbapenem-resistant Enterobacterales (CRE) infections represent a growing public health problem because they are difficult to treat and result in greater mortality. Few studies assess the risk factors for CRE infections in children, and additionally, few have focused exclusively on pediatric patients with CRE blood stream infections (BSI) though these infections can have substantial associated mortality.

Objective: The purpose of this study was to examine the characteristics of and risk factors associated with CRE BSI in children at Texas Children’s Hospital (TCH) between 2014 and 2019.

Design/Methods: We conducted a case-control study of patients hospitalized with CRE BSI at TCH between 2014-2019. Case patients were matched to two control patients each by age, underlying condition, year of BSI episode, and when possible, by genus and species of isolated organism. Descriptive statistics were used to compare cases and controls.

Results: There were 15 case patients with CRE BSI during the study period; most were adolescents (n=8, 53%) and of Hispanic/Latinx origin (n=8, 53%, p=0.82). Case patients had the following underlying conditions: bone marrow transplant (n=6, 40%), hematologic malignancies or other malignancies (n=3, 20%), gastrointestinal tract abnormality or short gut syndrome (n=3, 20%), genitourinary tract abnormality (n=2, 13%), and solid organ transplant (n=1, 7%). Compared to controls (n=30), case patients had longer median length of B-lactam use (p=0.01) and were more likely to be critically ill (p=0.006). There was no difference in mortality (p=0.38) or length of hospital stay (p=0.07) (Table 1).Conclusion(s): Compared to control patients, case patients with CRE BSI were more likely to have longer B-lactam exposure and be critically ill. There was no difference in length of hospital stay and mortality. Larger scale studies in children are needed to provide a contemporary characterization of CRE infections and develop mitigation strategies.
Melissa Kok, Medical Student - CVMKok_CV_10142021.pdf