Prevalence and Clinical Burden of NDM-1 Positive Infections in Pediatric and Neonatal Patients in Pakistan

Qamar, Muhammad Usman; Nahid, Fouzia; Walsh, Timothy R.; Kamran, Rubina; Zahra, Rabaab

doi:10.1097/inf.0000000000000582

Cited by 24 publications

(16 citation statements)

References 9 publications

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“…Internationally, Greece, Italy, the United Kingdom (UK), China, Pakistan, and Turkey have all described similarly small case series of CRE in children, with findings corroborating those from US studies [41–45, 50 53]. A report from Italy identified 15 CP-CRE isolates, of which 6 were associated with clinical infection, including 4 bacteremias and 2 UTIs.…”

Section: Epidemiology and Risk Factorssupporting

confidence: 55%

“…Patient-level risk factors for CRE infection in children include underlying chronic medical conditions, invasive medical devices, frequent or prolonged hospitalizations, prior antibiotic exposure, age, and travel from endemic regions [6, 35, 36, 39–44, 46, 48–50, 52, 53]. Neonates seem to be a particularly at risk group with several reported outbreaks of NDM-1-producing Enterobacteriaceae in the neonatal population in the Indian subcontinent [35, 37, 47, 51].…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Carbapenem-Resistant Enterobacteriaceae Infections in Children

Chiotos

Han

Tamma

2015

Curr Infect Dis Rep

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Carbapenem-resistant Enterobacteriaceae (CRE) are an emerging global public health threat. Infections due to CRE are associated with significant morbidity and mortality. Few therapeutic options are available for treatment of these infections, and optimal antibiotic treatment regimens are unclear. Along with the rapidly increasing prevalence of CRE in the United States and worldwide, several studies have described the epidemiology of CRE in the adult population. While CRE is now also reported sporadically in children, there is a significant lack of data on the epidemiology, risk factors, treatment, and outcomes in this population. This article provides a comprehensive review of what is known to date about CRE, including clinical and molecular epidemiology, microbiologic diagnosis, antibiotic treatment options, and outcomes. In particular, this review will focus on the available data on CRE in the pediatric population.

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Section: Epidemiology and Risk Factorssupporting

confidence: 55%

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Carbapenem-Resistant Enterobacteriaceae Infections in Children

Chiotos

Han

Tamma

2015

Curr Infect Dis Rep

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“…Another study from Pakistan testified that 37 out of 78 new-borns died due to infections caused by MDR-Acinetobacter spp., [11]. Qamar et al, conducted a study in Islamabad, Pakistan also reported 4/9 children died due to NDM positive isolates mainly of E. coli and K. pneumoniae [12]. Recently, Khan et al, from Karachi, Pakistan also reported that 22 with <1 month of age and 10 were elderly patients died due to bacteraemia and septicaemia which was mainly caused by NDM positive K. pneumoniae [13].…”

Section: Mortality Morbidity and Economic Burden Due To Antimicrobiamentioning

confidence: 99%

“…NDM producing bacteria notable K. pneumoniae and E. coli are major cause of morbidity and mortality in developing countries. Qamar et al reported 4/9 children died due to NDM producing bacteria [12]. Similarly, another study from Karachi, Pakistan also documented 57% mortality in neonates due to NDM producing bacteria mainly K. pneumoniae [13].…”

Section: Class B Carbapenemase Producing K Pneumoniaementioning

confidence: 99%

Antimicrobial Resistance

Qamar¹,

Rasool²,

Jahan³

et al. 2019

Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods

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Klebsiella pneumoniae (K. pneumoniae) pose an emerging threat to public health sector worldwide. They are one of the potent nosocomial pathogens and cause variety of infections including pneumonia, septicaemia, wound infections, urinary tract infections and catheter-associated infections. From the last two decades, these pathogens are becoming more powerful due to the acquisition of resistomes on different types of plasmids and transposons. There are four main mechanisms of antibacterial resistance such as efflux pump, target alteration, membrane permeability and notably enzymes hydrolysis. K. pneumoniae produce different types of enzymes but most importantly extended spectrum-β-lactamase (ESBL), carbapenemase and metallo-β-lactamase (MBL). K. pneumoniae carbapenemases (KPCs) and New Delhi metallo-β-lactamase (NDM) producing isolates displayed resistance not only against the β-lactam drugs (penicillins, cephalosporins and carbapenems) but also to other classes of antibiotics (aminoglycosides and quinolones). Therapeutic options available to treat serious infections caused by these extensively drug-resistant pathogens are limited to colistin, tigecycline and fosfomycin. Hence, combination therapy has also been recommended to treat such bacteria with clinical side effects, therefore, new treatment regime must be required. Moreover, we are relying on conventional diagnostic tools, however, novel techniques must be required for robust identification of multi-drug-resistant bacteria.

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“…Previously, we reported that 4/9 pediatrics who had been hospitalized in Islamabad, Pakistan died due to NDM producing bacteria [4]. Recently, another study revealed that 57% and 60% adult and neonatal patients died respectively in Karachi, Pakistan and the chief pathogen was NDM-1 positive K. penumoniae [5].…”

Section: Introductionmentioning

confidence: 99%