Frequency of Bacteremia due to Carbapenemase-producing Enterobacteriaceae in Pediatric Hematology-Oncology Can Be Reduced by Measures of Hospital Infection Control

Abstract

Objectives: The spread of carbapenemase-producing Enterobacteriaceae (CPE) is an emerging problem in children undergoing cancer-directed chemotherapy. A previous Italian survey reported a threefold increase in CPE colonization rate and a fourfold increase of CPE bloodstream infections in a 2 year-observation time interval. Methods: To assess the efficacy of the measures put in place to control this emergency, a second survey was performed in the years 2016-2017 and the results were compared. Results: The overall rate of colonization was comparable between the two study periods: 0.50% (2016-2017) vs. 0.48% (2012-2013). MDR/CPE bacteremia was now reported in 13 children from six centers. The rate of MDR/CPE bacteremia was 0.12 for 1,000 days of hospitalization (95% CI, 0.07-0.21) and compared favorably with that observed in the previous survey (0.42 for 1,000 days of hospitalization; 95% CI, 0.31-0.57; p