Article in Japanese

Multidrug-resistant organisms screening for expatriate children

Nobuhiro Kanie^1）, Hanako Funakoshi^1）, Meiwa Shibata^1）, Tomoyuki Tame^2）, Kazue Kinoshita^3）, Yuho Horikoshi^1）

＜Introduction＞ Carbapenemase-Producing Enterobacterales （CPE） and Vancomycin-Resistant Enterococci （VRE） are significant threats to hospital infection control. This study aimed to evaluate the feasibility and cost-effectiveness of screening for these multidrug-resistant organisms （MDROs） in pediatric patients with recent international travel history.
＜Methods＞ Children aged 18 years or younger with an expatriate history were enrolled in this study retrospectively at Tokyo Metropolitan Children’s Medical Center between January 2019 and April 2023. Stool cultures were performed for patients with a history of hospitalization or residence while being abroad. Genotyping of carbapenemases and VREs was performed using polymerase chain reaction （PCR） for confirmation. Information about CPE cases detected outside the screening program was extracted from electronic medical records. A cost-effectiveness analysis of the screening program was performed.
＜Results＞ A total of 148 children underwent screening. CPE and VRE were detected in three （2.0%） and none, respectively. Genotyping revealed VIM, OXA-48-like, and NDM. One child had a history of hospitalization while being abroad. CPE cases detected outside the screening program were all IMP-type, without hospitalization or residence abroad. The cost of the screening program during the above period was approximately 1.8 million yen, while the estimated cost of a single large-scale outbreak was calculated at 172.94 million yen. ＜Conclusion＞ Screening for multidrug-resistant organisms in children with an expatriate history may help to prevent nosocomial infections.

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1） Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children’s Medical Center
2） Division of Laboratory, Tokyo Metropolitan Children’s Medical Center
3） Division of Molecular Laboratory, Tokyo Metropolitan Children’s Medical Center

Key words	CPE, expatriate, hospital-acquired infection, antibiotic-resistant bacteria, screening
Received	April 21, 2024
Accepted	March 22, 2025

37 (2)：147─154,2025