Risk Factors Associated with ESBL and CPE Acquisition among ‎Pediatrics: A Systematic Review

Aims: Infections by extended-spectrum beta-lactamase (ESBL) and carbapenemase-producing Enterobacteriaceae (CPE) are increasing problems in pediatrics and are usually associated with higher hospital costs and mortality rates. The aims of this study were the statistical investigation of the worldwide prevalence and risk factors of ESBL and CPE family members among pediatric population.
Instruments and From October 1, 1995 to July 27, 2017, some keywords including “ESBLs”, “carbapenemase”, “pediatrics”, “children”, and “risk factor” were searched in the searching databases such as Google Scholar, Embase, Scopus, PubMed, and Web of Science among original research articles. The univariate and multivariate analysis of the collected data was performed by Graph Pad Prism 6.1 software.
Findings: The mean percentage of ESBL production was 20.23±22.31 and the mean percentage of CPE was 1.81±2.77. E. coli (n=991) and K. pneumonia (n=627) were the predominant ESBL-producers. Nephrology (n=5005) and NICU (n=1805) were predominant hospital wards. ESBL-PE had significantly higher prevalence in the infants unit (OR=0.9832, 95% CI=12.271-19.519; p Most of risk factors between ESBL-PE and CPE are similar including previous hospitalization and prolonged use of antibiotics, cephalosporins, and previous colonization. Other possible potential risk factors that should be considered include presence of catheters and travel history. Detection of risk factors provides useful information for formulation of infection control policy.