Superbugs on the rise in pediatric patients, US data show

Halfpoint / iStock An increase in superbug infections in US hospitals appears to be affecting children with complex medical needs, US researchers reported this week in the Journal of the Pediatric Infectious Diseases Society. Recent surveillance studies by the Centers for Disease Control and Prevention (CDC) have shown a significant increase in hospital infections caused by carbapenem-resistant Enterobacterales (CRE), a family of bacterial pathogens that has become resistant to most antibiotics.

The increase has been driven by carbapenemase-producing (CP)-CRE that carry the carbapenemase gene New Delhi metallo-beta-lactamase (NDM). But data on CRE and CP-CRE infections in pediatric patients have been limited. To assess trends in pediatric CRE and CP-CRE incidence in US hospitals, a team led by researchers with the CDC analyzed CRE clinical isolates from patients aged 18 and under that were submitted to the CDC’s Antimicrobial Resistance Laboratory Network from 2019 through 2024.

“Recent increases in the incidence of NDM-producing CRE pose new challenges for managing CRE infections,” the study authors wrote. “These challenges are accentuated in pediatric populations, where approval and age-specific safety data are limited or unavailable for newer therapies that have expanded CP-CRE treatment options in adults.” A 4-fold rise in NDM-CRE infections Overall, researchers identified 1,845 CRE cases from 1,753 children (median age, 5 years; 58% female).

One quarter of the cases were CP-CRE. Over the study period, national incidence of pediatric CRE rose 51%, while CP-CRE incidence saw a 92% increase. The increase was driven by a four-fold rise in NDM-CRE infections in children.

Analysis of medical charts of 124 children with CP-CRE infections found that only 14% were in children with no healthcare risk factors. Among those with healthcare risk factors, 75% had an underlying medical condition, including cardiovascular disease, malignancies, and neurocognitive conditions.

Common exposures included intensive care unit hospitalization and healthcare provided outside the United States. “These findings indicate that CP-CRE—and particularly NDM-CRE, with its more limited treatment options—is a growing issue in U.S. pediatric healthcare settings,” the authors wrote.