Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Increased 30-Day Mortality with CRE in Children

Open Forum Infect Dis; ePub 2018 Sep 10; Chiotos, et al

There is an increased risk of 30-day mortality among hospitalized children with carbapenem-resistant Enterobacteriaceae (CRE) isolated from clinical cultures compared to those with carbapenem-susceptible Enterobacteriaceae (CSE), with significant variation in antibiotic treatment for those with CRE infections. This according to a multicenter matched cohort study that assessed the impact of isolation of CRE from a clinical culture on 30-day all-cause mortality relative to isolation of CSE. All patients aged <21 years hospitalized at 3 different hospitals between January 1, 2011, and July 1, 2016 were eligible for inclusion. Patients with index clinical cultures positive for CRE were matched in a 2:1 ratio to those with clinical cultures positive for CSE. Researchers found:

  • During the 5.5-year study period, 72 patients with a clinical culture positive for CRE were identified and matched to 144 control patients with a clinical culture positive for CSE.
  • Patients with CRE had a 6-fold greater risk of mortality relative to patients with CSE.
  • There was significant variation in antibiotic treatment strategies among infected patients.


Chiotos K, Tamma PD, Flett KB, et al. Increased 30-day mortality associated with carbapenem-resistant Enterobacteriaceae in children. [Published online ahead of print September 10, 2018]. Open Forum Infect Dis. doi:10.1093/ofid/ofy222.

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