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Int J Appl Basic Med Res. 2018 Oct-Dec;8(4):263-265. doi: 10.4103/ijabmr.IJABMR_383_17.

Sepsis in a 4-Month-Old Boy Due to Carbapenem-Resistant Enterobacteriaceae Characterized by AmpC β-Lactamase with Porin Loss.

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Department of Emergency and Intensive Care Unit, Shiga University of Medical Science, Otsu, Shiga, Japan.
Department of Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan.


The incidence of carbapenem-resistant Enterobacteriaceae (CRE) infections is increasing, and these infections are associated with both morbidity and mortality. However, little is known about CRE infections in children. This article is a case report describing a 4-month-old boy with Langerhans histiocytosis who developed septic shock due to a CRE infection. The mechanism of carbapenem resistance was identified as AmpC β-lactamase hyperproduction with porin loss. The patient was treated with antibiotics, volume resuscitation, and vasopressors; however, he died of multiorgan failure due to CRE infection. Clinicians should be aware of the prevalence of CRE and the importance of prevention strategies against infection with multidrug-resistant bacteria, even in pediatric populations.


Carbapenem resistant; children; porin; sepsis; β-lactamase

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