Carbapenem-Resistant Infections in Neonates and Children in Latin America: A Literature Review

Gabriella Shanks Charité–Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany;

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Louis Grandjean Institute of Child Health, University College London, London, United Kingdom

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ABSTRACT.

Carbapenems are broad-spectrum beta-lactam antibiotics that are increasingly being used worldwide to treat multidrug-resistant infections, but since their introduction, carbapenem resistance has emerged. This phenomenon has been well documented in the adult population, but there is a paucity of evidence from the neonatal and pediatric populations. A literature search of carbapenem-resistant infections in Latin American neonates and children was conducted via PubMed/Medline and SCOPUS: 551 titles were screened, and 17 articles were included in the review. The most commonly reported predominant isolate was Klebsiella pneumoniae (11 of 17 studies). Genotypic data were available in 10 of 17 studies, and the KPC gene was the most commonly reported resistance gene. The mortality rate ranged from 13% to 52.6%. Carbapenem-resistant infections are prevalent in children and neonates in Latin America and are associated with high rates of mortality, highlighting the need for enhanced antimicrobial stewardship and surveillance within these populations.

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Author Notes

Current contact information: Gabriella Shanks, Royal London Hospital, London, United Kingdon, E-mail: gabriella.shanks1@nhs.net. Louis Grandjean, Institute of Child Health, University College London, London, United Kingdon, E-mail: l.grandjean@ucl.ac.uk.

Address correspondence to Gabriella Shanks, Charité–Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany. E-mails: gabriella.shanks@charite.de or gabriella.shanks1@nhs.net
  • 1.

    World Health Organization, 2015. Global Action Plan on Antimicrobial Resistance. Available at: https://iris.who.int/handle/10665/193736. Accessed December 21, 2023.

    • PubMed
    • Export Citation
  • 2.

    World Health Organization, 2022. The WHO AWaRe (Access, Watch, Reserve) Antibiotic Book. Geneva, Switzerland: WHO.

  • 3.

    Otaigbe II, Elikwu CJ, 2023. Drivers of inappropriate antibiotic use in low- and middle-income countries. JAC Antimicrob Resist 5: dlad062.

  • 4.

    Antimicrobial Resistance Collaborators, 2023. The burden of antimicrobial resistance in the Americas in 2019: A cross-country systematic analysis. Lancet Reg Health Am 25: 100561.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Brink AJ, 2019. Epidemiology of carbapenem-resistant Gram-negative infections globally. Curr Opin Infect Dis 32: 609616.

  • 6.

    Chiotos K, Han JH, Tamma PD, 2016. Carbapenem-resistant Enterobacteriaceae infections in children. Curr Infect Dis Rep 18: 2.

  • 7.

    Oliveira PMND, Buonora SN, Souza CLP, Simões Júnior R, Silva TCD, Bom GJT, Teixeira CHDS, Silva ARAD, 2019. Surveillance of multidrug-resistant bacteria in pediatric and neonatal intensive care units in Rio de Janeiro State, Brazil. Rev Soc Bras Med Trop 52: e20190205.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Arnoni MV, Berezin EN, Martino MDV, 2007. Risk factors for nosocomial bloodstream infection caused by multidrug resistant gram-negative bacilli in pediatrics. Braz J Infect Dis 11: 267271.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Pellegrini JL, Aguirre C, Soto SM, Lovera LMR, Lösch LS, Conza JAD, Merino LA, 2022. Resistencia a colistina en aislados de Klebsiella pneumoniae resistente a carbapenémicos en un hospital pediátrico de Corrientes. Rev Chilena Infectol 39: 109116.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Cheguirián ML, Carvajal LR, Ledesma EM, Enrico MC, Reale AL, Culasso C, Bertoni L, 2008. Prevalence and antimicrobial susceptibility patterns of microorganisms causing bacteremia and fungemia in pediatric oncology patients. Rev Argent Microbiol 40: 111115.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Vanegas JM, Parra OL, Jiménez JN, 2016. Molecular epidemiology of carbapenem resistant gram-negative bacilli from infected pediatric population in tertiary-care hospitals in Medellín, Colombia: An increasing problem. BMC Infect Dis 16: 463.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Acuña MP, Cifuentes M, Silva F, Rojas Á, Cerda J, Labarca J, 2017. Incidencia de bacterias multi-resistentes en unidades de cuidados intensivos de hospitales chilenos. Rev Chilena Infectol 34: 570575.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Cerezales M, Ocampo-Sosa AA, Álvarez Montes L, Díaz Ríos C, Bustamante Z, Santos J, Martínez-Martínez L, Higgins PG, Gallego L, 2018. High prevalence of extensively drug-resistant Acinetobacter baumannii at a children hospital in Bolivia. Pediatr Infect Dis J 37: 11181123.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Sánchez-Álvarez BP, Rincón-Zuno J, Mejía-Caballero L, Hernández-Castellanos CA, Diaz-Conde M, Magaña-Matienzo I, Terrazas-Peraza AA, 2022. Current status of antimicrobial resistance in pediatric population in a Mexican hospital. Rev Med Inst Mex Seguro Soc 60: 371378.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Díaz A, Ortiz DC, Trujillo M, Garcés C, Jaimes F, Restrepo AV, 2016. Clinical characteristics of carbapenem-resistant Klebsiella pneumoniae infections in ill and colonized children in Colombia. Pediatr Infect Dis J 35: 237241.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Pérez-Corrales C, Peralta-Barquero V, Mairena-Acuña C, 2021. Carriage of two carbapenem-resistance genes in Pseudomonas aeruginosa isolated from hospital-acquired infections in children from Costa Rica: The importance of local epidemiology. Antimicrob Resist Infect Control 10: 71.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Alvares PA, Arnoni MV, Da Silva CB, Sáfadi MAP, Mimica MJ, 2019. Carbapenem-resistant Gram-negative bloodstream infections in critically ill children: Outcome and risk factors in a tertiary teaching hospital in South America. J Hosp Infect 101: 188189.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Bello-Suárez A, Cuesta-Armesto M, Díaz-Rojas M, Mendoza-Uribe L, Sarmiento-Wilches P, 2022. Caracterización microbiológica y de susceptibilidad antimicrobiana de las infecciones asociadas a neutropenia febril en pacientes hemato-oncológicos pediátricos. Andes Pediatr 93: 6577.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Graff KE, Windsor WJ, Calvimontes DM, Melgar MA, Galvez N, Rivera JG, Dominguez SR, Asturias EJ, Gordillo MR, 2021. Antimicrobial resistance trends at a pediatric hospital in Guatemala City, 2005–2019. J Pediatric Infect Dis Soc 2021: piab048.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Amaya E, Reyes D, Vilchez S, Paniagua M, Möllby R, Nord CE, Weintraub A, 2011. Antibiotic resistance patterns of intestinal Escherichia coli isolates from Nicaraguan children. J Med Microbiol 60: 216222.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Falco A, Ramos Y, Franco E, Guzmán A, Takiff H, 2016. A cluster of KPC-2 and VIM-2-producing Klebsiella pneumoniae ST833 isolates from the pediatric service of a Venezuelan Hospital. BMC Infect Dis 16: 595.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Barroso MDV, da Silva CR, Benfatti LR, Gozi KS, de Andrade LK, Andrade LN, Estofolete CF, Nogueira MCL, Casella T, 2023. Characterization of KPC-2-producing Klebsiella pneumoniae and affected patients of a pediatric hospital in Brazil. Diagn Microbiol Infect Dis 106: 115932.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Ruvinsky S, et al., 2022. Carbapenem-resistant Enterobacteriaceae bloodstream infections: A case-control study from a pediatric referral hospital in Argentina. Front Public Health 10: 983174.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Pan American Health Organization, 2023. Organización Panamericana de la Salud. Available at: https://www.paho.org/pt/node/68930. Accessed October 9, 2024.

    • PubMed
    • Export Citation
  • 25.

    World Health Organization, 2022. Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report: 2022. Available at: https://www.who.int/publications/i/item/9789240062702. Accessed January 15, 2023.

    • PubMed
    • Export Citation
  • 26.

    Suwantarat N, Carroll KC, 2016. Epidemiology and molecular characterization of multidrug-resistant Gram-negative bacteria in Southeast Asia. Antimicrob Resist Infect Control 5: 15.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Grundmann H, et al., 2017. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): A prospective, multinational study. Lancet Infect Dis 17: 153163.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Bartolleti F, et al., 2016. Polymyxin B resistance in carbapenem-resistant Klebsiella pneumoniae, São Paulo, Brazil. Emerg Infect Dis 22: 18491851.

  • 29.

    Rodríguez CH, Nastro M, Famiglietti A, 2018. Carbapenemases in Acinetobacter baumannii. Review of their dissemination in Latin America. Rev Argent Microbiol 50: 327333.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Krapp F, et al., 2023. Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study. Am J Trop Med Hyg 109: 10951106.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Fisher M, Komarow L, Kahn J, Patel G, Revolinski S, Huskins WC, van Duin D, Banerjee R, Fries BC, 2024. Carbapenem-resistant Enterobacterales in children at 18 US health care system study sites: Clinical and molecular epidemiology from a prospective multicenter cohort study. Open Forum Infect Dis 11: ofad688.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Han R, et al., 2020. Dissemination of carbapenemases (KPC, NDM, OXA-48, IMP, and VIM) among carbapenem-resistant Enterobacteriaceae isolated from adult and children patients in China. Front Cell Infect Microbiol 10: 314.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Venuti F, Romani L, De Luca M, Tripiciano C, Palma P, Chiriaco M, Finocchi A, Lancella L, 2023. Novel beta lactam antibiotics for the treatment of multidrug-resistant gram-negative infections in children: A narrative review. Microorganisms 11: 1798.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Yu D, Zheng Y, Shen A, Wu F, Dmitriev AV, Kilian M, Yang Y, 2023. Editorial: Antimicrobial resistance in pediatric infectious diseases: Antimicrobial resistance, resistance mechanisms and antimicrobial use. Front Cell Infect Microbiol 13: 1287051.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Tamma PD, Goodman KE, Harris AD, Tekle T, Roberts A, Taiwo A, Simner PJ, 2017. Comparing the outcomes of patients with carbapenemase-producing and non-carbapenemase-producing carbapenem-resistant Enterobacteriaceae bacteremia. Clin Infect Dis 64: 257264.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Klein EY, Van Boeckel TP, Martinez EM, Pant S, Gandra S, Levin SA, Goossens H, Laxminarayan R, 2018. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proc Natl Acad Sci USA 115: E3463E3470.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Duffy N, et al., 2023. Trends in incidence of carbapenem-resistant Enterobacterales in 7 US sites, 2016–2020. Open Forum Infect Dis 10: ofad609.

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