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Purpose <p>MBL-producing organisms pose a major global health threat, yet data on their epidemiology, outcomes, and treatment in children remain limited. The aims of our study were to investigate the clinical outcomes, microbiological characteristics, treatment regimens, and risk factors associated with unfavorable outcomes.</p> Methods <p>A retrospective study was conducted at the Bambino Gesù Children’s Hospital in Rome (Italy) from January 2020 to December 2024 including pediatric patients with MBL-producing <i>Enterobacterales</i> (MBL-CRE) and MBL-producing <i>Pseudomonas aeruginosa</i> (MBL-CRPA) infections.</p> Results <p>Thirty-five pediatric patients were included. The median age was 2,3 years. 80% were critically ill children. 77% of patients were previously colonized by MBL producing organisms and a high concordance (89%) was observed between the colonizing and infective microorganism species. Most of the infections were hospital acquired (81%) and pneumonia was the most common infection (42%). The infection-attributable mortality rate was 14.2%. The most frequently detected microorganisms were MBL-producing CRPA (64%). Compared to <i>Pseudomonas</i> strains, <i>Enterobacterales</i> isolates showed higher susceptibility to aminoglycosides (p-value = 0.23) and lower susceptibility to fluoroquinolones (p-value = 0.0003). The most frequently detected MBL gene belonged to the VIM subgroup (80%). 30.5% of episodes were treated with a colistin - based regimen and 53% with ceftazidime/avibactam plus aztreonam. The analysis of risk factors showed that a higher Phoenix Sepsis Scores at diagnosis were significantly associated with an increased risk of negative outcomes (p-value 0.004; OR = 3.156).</p> Conclusion <p>Infections by Metallo-β-lactamase–producing organisms are a concern even in children, highlighting the need for rapid diagnostics and timely targeted therapy in high-resistance settings.</p>

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Clinical outcomes and therapeutic approaches in pediatric infections caused by metallo-β-lactamase–producing organisms: a five-year experience in a tertiary care hospital

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月30日

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  • Costanza Tripiciano,
  • Sarah Barni,
  • Paola Bernaschi,
  • Venere Cortazzo,
  • Gianluca Vrenna,
  • Lorenza Romani,
  • Gabriella Bottari,
  • Luigi Dei Giudici,
  • Tiziana Fragasso,
  • Francesca Tortora,
  • Marta Luisa Ciofi degli Atti,
  • Laura Lancella,
  • Maia De Luca

摘要

Purpose

MBL-producing organisms pose a major global health threat, yet data on their epidemiology, outcomes, and treatment in children remain limited. The aims of our study were to investigate the clinical outcomes, microbiological characteristics, treatment regimens, and risk factors associated with unfavorable outcomes.

Methods

A retrospective study was conducted at the Bambino Gesù Children’s Hospital in Rome (Italy) from January 2020 to December 2024 including pediatric patients with MBL-producing Enterobacterales (MBL-CRE) and MBL-producing Pseudomonas aeruginosa (MBL-CRPA) infections.

Results

Thirty-five pediatric patients were included. The median age was 2,3 years. 80% were critically ill children. 77% of patients were previously colonized by MBL producing organisms and a high concordance (89%) was observed between the colonizing and infective microorganism species. Most of the infections were hospital acquired (81%) and pneumonia was the most common infection (42%). The infection-attributable mortality rate was 14.2%. The most frequently detected microorganisms were MBL-producing CRPA (64%). Compared to Pseudomonas strains, Enterobacterales isolates showed higher susceptibility to aminoglycosides (p-value = 0.23) and lower susceptibility to fluoroquinolones (p-value = 0.0003). The most frequently detected MBL gene belonged to the VIM subgroup (80%). 30.5% of episodes were treated with a colistin - based regimen and 53% with ceftazidime/avibactam plus aztreonam. The analysis of risk factors showed that a higher Phoenix Sepsis Scores at diagnosis were significantly associated with an increased risk of negative outcomes (p-value 0.004; OR = 3.156).

Conclusion

Infections by Metallo-β-lactamase–producing organisms are a concern even in children, highlighting the need for rapid diagnostics and timely targeted therapy in high-resistance settings.