Association between the carbapenem-resistant Enterobacterales in clinical isolates of children and the use of antibiotics

Objective To investigate the relationship between carbapenem-resistant Enterobacterales (CRE) infections in children and clinical antibacterial drug use. Methods Hospitalized children who were admitted to Xuzhou Children's Hospital from October 2022 to December 2024 were selected and their clinical data were retrospectively analyzed. (Based on the sample size estimation formula, the estimated required sample size was 117 cases; finally, 100 cases met the inclusion criteria.) All specimens were tested for CRE, and antimicrobial susceptibility testing was performed for commonly used antibacterial agents. The types of isolated strains and their resistance profiles were analyzed. Results A total of 100 CRE isolates were identified, with Klebsiella pneumoniae (50 isolates, 50.00%), Escherichia coli (31 isolates, 31.00%), and Enterobacter cloacae (11 isolates, 11.00%) as the predominant organisms. K. pneumoniae showed 100% resistance to imipenem, meropenem, cefotaxime, ceftriaxone, and ampicillin; resistance rates to tetracycline, ciprofloxacin, cefotetan, and gentamicin were 88.00%, 80.00%, 78.00%, and 76.00%, respectively. E. coli exhibited 100% resistance to imipenem, meropenem, cefotaxime, and ceftriaxone; resistance rates to ciprofloxacin, cefotetan, ampicillin, and levofloxacin were 83.87%, 74.19%, 74.19%, and 70.97%, respectively. E. cloacae showed 100% resistance to cefotaxime and ceftriaxone, and 72.73% resistance to ampicillin. Conclusions The main pathogens causing clinical CRE infections in children were K. pneumoniae, E. coli, and E. cloacae. K. pneumoniae and E. coli demonstrate high resistance to commonly used antibacterial agents in clinical practice, while E. cloacae showed particularly prominent resistance to cefotaxime and ceftriaxone.