Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis

Autores
Ruvinsky, Silvina Denise; Voto, Carla; Roel, Macarena; Portillo, Victoria; Naranjo Zuñiga, Gabriela; Ulloa Gutierrez, Rolando; Comandé, Daniel; Ciapponi, Agustín; Aboud, Gabriela; Brizuela, Martín; Bardach, Ariel Esteban
Año de publicación
2024
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Data on the health impact of carbapenem-resistant Enterobacteriaceae bloodstream infections (CRE-BSIs) in pediatric populations from Latin America and the Caribbean (LAC) are limited. This systematic review aims to examine the demographic, clinical, and microbiological aspects and resource utilization of this infection in children from this region. Methods: This systematic review investigates the impact of CRE-BSIs in pediatric populations across LAC. Following the Cochrane methodology and PRISMA/MOOSE guidelines, we conducted an extensive search of different databases, including MEDLINE/PubMed, LILACS (SciELO), CENTRAL, CINAHL, Embase (Ovid), the Cochrane Library, and the World Health Organization (WHO) database, and relevant websites for published articles between January 2012 and September 2024. The review included studies on hospitalized patients under 19 years of age with CRE-BSIs. Results: Fourteen studies involving 189 patients were analyzed. Most cases were reported from Brazil, Argentina, Colombia, and Paraguay. The median age of the patients was 35 months. Key risk factors included immunocompromised status, invasive procedures, carbapenem use, and colonization. The infections were predominantly hospital-acquired, with Klebsiella pneumoniae and Serratia spp. being the most common pathogens. KPC and NDM were the primary resistance mechanisms. Most patients received combination antimicrobial therapy for a median of 17 days. An alarmingly high mortality rate at 34% was found. Conclusions: Our findings highlight that CRE-BSIs pose a significant threat to children with underlying conditions in LAC, leading to substantial morbidity and mortality. Implementing robust antimicrobial stewardship programs and effective infection control measures are crucial to curbing the spread of CRE-BSIs in the region. This review underscores the need for targeted interventions and further research to address this critical public health concern in pediatric populations across LAC.
Fil: Ruvinsky, Silvina Denise. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Voto, Carla. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Roel, Macarena. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Portillo, Victoria. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Naranjo Zuñiga, Gabriela. Hospital Nacional de Niños Dr. Carlos Sáenz Herrera; Costa Rica
Fil: Ulloa Gutierrez, Rolando. Hospital Nacional de Niños Dr. Carlos Sáenz Herrera; Costa Rica
Fil: Comandé, Daniel. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Aboud, Gabriela. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Brizuela, Martín. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital General de Agudos "Dalmacio Vélez Sarsfield";
Fil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Materia
CARBAPENEM-RESISTANT ENTEROBACTERIACEAE
CHILD
LATIN AMERICA
CARIBBEAN
SYSTEMATIC REVIEW
META-ANALYSIS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/266214
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/266214
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-AnalysisRuvinsky, Silvina DeniseVoto, CarlaRoel, MacarenaPortillo, VictoriaNaranjo Zuñiga, GabrielaUlloa Gutierrez, RolandoComandé, DanielCiapponi, AgustínAboud, GabrielaBrizuela, MartínBardach, Ariel EstebanCARBAPENEM-RESISTANT ENTEROBACTERIACEAECHILDLATIN AMERICACARIBBEANSYSTEMATIC REVIEWMETA-ANALYSIShttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: Data on the health impact of carbapenem-resistant Enterobacteriaceae bloodstream infections (CRE-BSIs) in pediatric populations from Latin America and the Caribbean (LAC) are limited. This systematic review aims to examine the demographic, clinical, and microbiological aspects and resource utilization of this infection in children from this region. Methods: This systematic review investigates the impact of CRE-BSIs in pediatric populations across LAC. Following the Cochrane methodology and PRISMA/MOOSE guidelines, we conducted an extensive search of different databases, including MEDLINE/PubMed, LILACS (SciELO), CENTRAL, CINAHL, Embase (Ovid), the Cochrane Library, and the World Health Organization (WHO) database, and relevant websites for published articles between January 2012 and September 2024. The review included studies on hospitalized patients under 19 years of age with CRE-BSIs. Results: Fourteen studies involving 189 patients were analyzed. Most cases were reported from Brazil, Argentina, Colombia, and Paraguay. The median age of the patients was 35 months. Key risk factors included immunocompromised status, invasive procedures, carbapenem use, and colonization. The infections were predominantly hospital-acquired, with Klebsiella pneumoniae and Serratia spp. being the most common pathogens. KPC and NDM were the primary resistance mechanisms. Most patients received combination antimicrobial therapy for a median of 17 days. An alarmingly high mortality rate at 34% was found. Conclusions: Our findings highlight that CRE-BSIs pose a significant threat to children with underlying conditions in LAC, leading to substantial morbidity and mortality. Implementing robust antimicrobial stewardship programs and effective infection control measures are crucial to curbing the spread of CRE-BSIs in the region. This review underscores the need for targeted interventions and further research to address this critical public health concern in pediatric populations across LAC.Fil: Ruvinsky, Silvina Denise. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Voto, Carla. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Roel, Macarena. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Portillo, Victoria. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Naranjo Zuñiga, Gabriela. Hospital Nacional de Niños Dr. Carlos Sáenz Herrera; Costa RicaFil: Ulloa Gutierrez, Rolando. Hospital Nacional de Niños Dr. Carlos Sáenz Herrera; Costa RicaFil: Comandé, Daniel. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Aboud, Gabriela. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Brizuela, Martín. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital General de Agudos "Dalmacio Vélez Sarsfield";Fil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaMDPI2024-11info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/266214Ruvinsky, Silvina Denise; Voto, Carla; Roel, Macarena; Portillo, Victoria; Naranjo Zuñiga, Gabriela; et al.; Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis; MDPI; Antibiotics; 13; 12; 11-2024; 1-122079-6382CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.mdpi.com/2079-6382/13/12/1117info:eu-repo/semantics/altIdentifier/doi/10.3390/antibiotics13121117info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-10-15T15:03:27Zoai:ri.conicet.gov.ar:11336/266214instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-10-15 15:03:27.968CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis
title Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis
spellingShingle Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis
Ruvinsky, Silvina Denise
CARBAPENEM-RESISTANT ENTEROBACTERIACEAE
CHILD
LATIN AMERICA
CARIBBEAN
SYSTEMATIC REVIEW
META-ANALYSIS
title_short Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis
title_full Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis
title_fullStr Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis
title_full_unstemmed Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis
title_sort Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis
dc.creator.none.fl_str_mv Ruvinsky, Silvina Denise
Voto, Carla
Roel, Macarena
Portillo, Victoria
Naranjo Zuñiga, Gabriela
Ulloa Gutierrez, Rolando
Comandé, Daniel
Ciapponi, Agustín
Aboud, Gabriela
Brizuela, Martín
Bardach, Ariel Esteban
author Ruvinsky, Silvina Denise
author_facet Ruvinsky, Silvina Denise
Voto, Carla
Roel, Macarena
Portillo, Victoria
Naranjo Zuñiga, Gabriela
Ulloa Gutierrez, Rolando
Comandé, Daniel
Ciapponi, Agustín
Aboud, Gabriela
Brizuela, Martín
Bardach, Ariel Esteban
author_role author
author2 Voto, Carla
Roel, Macarena
Portillo, Victoria
Naranjo Zuñiga, Gabriela
Ulloa Gutierrez, Rolando
Comandé, Daniel
Ciapponi, Agustín
Aboud, Gabriela
Brizuela, Martín
Bardach, Ariel Esteban
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv CARBAPENEM-RESISTANT ENTEROBACTERIACEAE
CHILD
LATIN AMERICA
CARIBBEAN
SYSTEMATIC REVIEW
META-ANALYSIS
topic CARBAPENEM-RESISTANT ENTEROBACTERIACEAE
CHILD
LATIN AMERICA
CARIBBEAN
SYSTEMATIC REVIEW
META-ANALYSIS
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: Data on the health impact of carbapenem-resistant Enterobacteriaceae bloodstream infections (CRE-BSIs) in pediatric populations from Latin America and the Caribbean (LAC) are limited. This systematic review aims to examine the demographic, clinical, and microbiological aspects and resource utilization of this infection in children from this region. Methods: This systematic review investigates the impact of CRE-BSIs in pediatric populations across LAC. Following the Cochrane methodology and PRISMA/MOOSE guidelines, we conducted an extensive search of different databases, including MEDLINE/PubMed, LILACS (SciELO), CENTRAL, CINAHL, Embase (Ovid), the Cochrane Library, and the World Health Organization (WHO) database, and relevant websites for published articles between January 2012 and September 2024. The review included studies on hospitalized patients under 19 years of age with CRE-BSIs. Results: Fourteen studies involving 189 patients were analyzed. Most cases were reported from Brazil, Argentina, Colombia, and Paraguay. The median age of the patients was 35 months. Key risk factors included immunocompromised status, invasive procedures, carbapenem use, and colonization. The infections were predominantly hospital-acquired, with Klebsiella pneumoniae and Serratia spp. being the most common pathogens. KPC and NDM were the primary resistance mechanisms. Most patients received combination antimicrobial therapy for a median of 17 days. An alarmingly high mortality rate at 34% was found. Conclusions: Our findings highlight that CRE-BSIs pose a significant threat to children with underlying conditions in LAC, leading to substantial morbidity and mortality. Implementing robust antimicrobial stewardship programs and effective infection control measures are crucial to curbing the spread of CRE-BSIs in the region. This review underscores the need for targeted interventions and further research to address this critical public health concern in pediatric populations across LAC.
Fil: Ruvinsky, Silvina Denise. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Voto, Carla. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Roel, Macarena. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Portillo, Victoria. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Naranjo Zuñiga, Gabriela. Hospital Nacional de Niños Dr. Carlos Sáenz Herrera; Costa Rica
Fil: Ulloa Gutierrez, Rolando. Hospital Nacional de Niños Dr. Carlos Sáenz Herrera; Costa Rica
Fil: Comandé, Daniel. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Aboud, Gabriela. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina
Fil: Brizuela, Martín. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital General de Agudos "Dalmacio Vélez Sarsfield";
Fil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
description Background: Data on the health impact of carbapenem-resistant Enterobacteriaceae bloodstream infections (CRE-BSIs) in pediatric populations from Latin America and the Caribbean (LAC) are limited. This systematic review aims to examine the demographic, clinical, and microbiological aspects and resource utilization of this infection in children from this region. Methods: This systematic review investigates the impact of CRE-BSIs in pediatric populations across LAC. Following the Cochrane methodology and PRISMA/MOOSE guidelines, we conducted an extensive search of different databases, including MEDLINE/PubMed, LILACS (SciELO), CENTRAL, CINAHL, Embase (Ovid), the Cochrane Library, and the World Health Organization (WHO) database, and relevant websites for published articles between January 2012 and September 2024. The review included studies on hospitalized patients under 19 years of age with CRE-BSIs. Results: Fourteen studies involving 189 patients were analyzed. Most cases were reported from Brazil, Argentina, Colombia, and Paraguay. The median age of the patients was 35 months. Key risk factors included immunocompromised status, invasive procedures, carbapenem use, and colonization. The infections were predominantly hospital-acquired, with Klebsiella pneumoniae and Serratia spp. being the most common pathogens. KPC and NDM were the primary resistance mechanisms. Most patients received combination antimicrobial therapy for a median of 17 days. An alarmingly high mortality rate at 34% was found. Conclusions: Our findings highlight that CRE-BSIs pose a significant threat to children with underlying conditions in LAC, leading to substantial morbidity and mortality. Implementing robust antimicrobial stewardship programs and effective infection control measures are crucial to curbing the spread of CRE-BSIs in the region. This review underscores the need for targeted interventions and further research to address this critical public health concern in pediatric populations across LAC.
publishDate 2024
dc.date.none.fl_str_mv 2024-11
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/266214
Ruvinsky, Silvina Denise; Voto, Carla; Roel, Macarena; Portillo, Victoria; Naranjo Zuñiga, Gabriela; et al.; Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis; MDPI; Antibiotics; 13; 12; 11-2024; 1-12
2079-6382
CONICET Digital
CONICET
url http://hdl.handle.net/11336/266214
identifier_str_mv Ruvinsky, Silvina Denise; Voto, Carla; Roel, Macarena; Portillo, Victoria; Naranjo Zuñiga, Gabriela; et al.; Carbapenem-Resistant Enterobacteriaceae Bacteremia in Pediatric Patients in Latin America and the Caribbean: A Systematic Review and Meta-Analysis; MDPI; Antibiotics; 13; 12; 11-2024; 1-12
2079-6382
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.mdpi.com/2079-6382/13/12/1117
info:eu-repo/semantics/altIdentifier/doi/10.3390/antibiotics13121117
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
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publisher.none.fl_str_mv MDPI
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reponame_str CONICET Digital (CONICET)
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instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
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repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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