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Background <p>Carbapenem-resistant <i>Enterobacterales</i> are increasingly reported worldwide, posing significant treatment challenges, especially in vulnerable pediatric populations. This study describes the molecular epidemiology and antimicrobial susceptibility of carbapenem-resistant <i>Enterobacterales</i> isolated from infants under one year of age in Niger. This prospective case series reports on 14 children &lt; 1 year old with carbapenem-resistant <i>Enterobacterales</i> isolates.</p> Results <p>A total of 14 isolates were analyzed, predominantly <i>Escherichia coli</i> (78.6%; <i>n</i> = 11), followed by <i>Serratia odorifera</i> (7.1%, <i>n</i> = 1), <i>Klebsiella pneumoniae</i> (7.1%, <i>n</i> = 1), and <i>Klebsiella oxytoca</i> (7.1%, <i>n</i> = 1). The <i>bla</i><sub>NDM</sub> gene was the most frequently detected carbapenemase, found in 7 isolates (50.0%), followed by <i>bla</i><sub>VIM</sub> in 4 isolates (28.6%), <i>bla</i><sub>KPC</sub> in 2 isolates (14.3%), and <i>bla</i><sub>OXA−48</sub> in 1 isolate (7.1%). High resistance rates to fluoroquinolones and aminoglycosides were observed, with moderate fosfomycin activity. Cefiderocol, tigecycline, and eravacycline demonstrated preserved activity across carbapenemase genotypes, whereas ceftazidime–avibactam showed limited activity against metallo-β-lactamase producers. An apparent relationship between carbapenemase genotype and multidrug resistance phenotype was observed.</p> Conclusions <p>Carbapenem-resistant <i>Enterobacterales</i> isolates in infants under one year of age represent a major clinical challenge in Niger. The predominance of <i>bla</i><sub>NDM</sub> producing organisms, combined with high levels of resistance to commonly used antibiotics, limits the effectiveness of standard empirical therapies. Cefiderocol and tetracycline derivatives exhibit promising activity and may inform treatment strategies where available. Regional differences in carbapenemase epidemiology underscore the need for enhanced surveillance and stewardship.</p>

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High prevalence of blaNDM gene among a series of carbapenem-resistant Enterobacterales isolates from children less than one year old in Niger

  • 期刊论文

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  • 发表日期：

    2026年4月24日

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  • Issoufou Noma Massir,
  • Yacouba Abdourahamane,
  • Tapha Ounoussa,
  • Hamidou Oumou,
  • Ousmane Abdoulaye,
  • Aminatou Ousmane,
  • Moussa Harouna,
  • Brah Souleymane,
  • Mahamadou Doutchi,
  • Mamadou Saidou,
  • Ibrahim Mamane Laminou

摘要

Background

Carbapenem-resistant Enterobacterales are increasingly reported worldwide, posing significant treatment challenges, especially in vulnerable pediatric populations. This study describes the molecular epidemiology and antimicrobial susceptibility of carbapenem-resistant Enterobacterales isolated from infants under one year of age in Niger. This prospective case series reports on 14 children < 1 year old with carbapenem-resistant Enterobacterales isolates.

Results

A total of 14 isolates were analyzed, predominantly Escherichia coli (78.6%; n = 11), followed by Serratia odorifera (7.1%, n = 1), Klebsiella pneumoniae (7.1%, n = 1), and Klebsiella oxytoca (7.1%, n = 1). The blaNDM gene was the most frequently detected carbapenemase, found in 7 isolates (50.0%), followed by blaVIM in 4 isolates (28.6%), blaKPC in 2 isolates (14.3%), and blaOXA−48 in 1 isolate (7.1%). High resistance rates to fluoroquinolones and aminoglycosides were observed, with moderate fosfomycin activity. Cefiderocol, tigecycline, and eravacycline demonstrated preserved activity across carbapenemase genotypes, whereas ceftazidime–avibactam showed limited activity against metallo-β-lactamase producers. An apparent relationship between carbapenemase genotype and multidrug resistance phenotype was observed.

Conclusions

Carbapenem-resistant Enterobacterales isolates in infants under one year of age represent a major clinical challenge in Niger. The predominance of blaNDM producing organisms, combined with high levels of resistance to commonly used antibiotics, limits the effectiveness of standard empirical therapies. Cefiderocol and tetracycline derivatives exhibit promising activity and may inform treatment strategies where available. Regional differences in carbapenemase epidemiology underscore the need for enhanced surveillance and stewardship.