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Urinary tract infection caused by community-acquired extended-spectrum β-lactamase-producing bacteria in infants.
J Pediatr (Rio J) 2017 May - Jun; 93(3):260-266JP

Abstract

OBJECTIVE

Urinary tract infection (UTI) caused by resistant strains of bacteria is increasingly prevalent in children. The aim of this study was to investigate the clinical characteristics and risk factors for UTI caused by community-acquired extended-spectrum β-lactamase (CA-ESBL)-producing bacteria in infants.

METHODS

This was a retrospective study performed over 5 years in a single Korean center. Hospitalized infants with febrile UTI were enrolled and divided into two groups (CA-ESBL vs. CA non-ESBL UTI). The yearly prevalence was calculated. Baseline characteristics and clinical course such as fever duration, laboratory and radiological findings were compared between the two groups. Risk factors associated with the CA-ESBL UTI were investigated.

RESULTS

Among the enrolled infants (n=185), 31 (17%) had CA-ESBL UTI. The yearly prevalence of ESBL of CA-ESBL UTI increased during the study (0% in 2010, 22.2% in 2015). Infants with CA-ESBL UTI had a longer duration of fever after initiating antibiotics (2.0±1.1 vs. 1.5±0.6 days, p=0.020). Cortical defects on renal scan and early treatment failure were more frequent in CA-ESBL (64.5 vs. 42.2%, p=0.023; 22.6 vs. 4.5%, p=0.001). A logistic regression analysis revealed that urinary tract abnormalities and previous UTI were independent risk factors for CA-EBSL UTI (odds ratio, 2.7; p=0.025; 10.3; p=0.022).

CONCLUSION

The incidence of UTI caused by ESBL-producing bacteria has increased in Korean infants. Recognition of the clinical course and risk factors for ESLB-producing UTI may help to determine appropriate guidelines for its management.

Authors+Show Affiliations

Chonnam National University Hospital, Gwangju, Republic of Korea.Chonnam National University Hospital, Gwangju, Republic of Korea. Electronic address: emyang@chonnam.ac.kr.Chonnam National University Hospital, Gwangju, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27842212

Citation

Kim, Yun Hee, et al. "Urinary Tract Infection Caused By Community-acquired Extended-spectrum Β-lactamase-producing Bacteria in Infants." Jornal De Pediatria, vol. 93, no. 3, 2017, pp. 260-266.
Kim YH, Yang EM, Kim CJ. Urinary tract infection caused by community-acquired extended-spectrum β-lactamase-producing bacteria in infants. J Pediatr (Rio J). 2017;93(3):260-266.
Kim, Y. H., Yang, E. M., & Kim, C. J. (2017). Urinary tract infection caused by community-acquired extended-spectrum β-lactamase-producing bacteria in infants. Jornal De Pediatria, 93(3), pp. 260-266. doi:10.1016/j.jped.2016.06.009.
Kim YH, Yang EM, Kim CJ. Urinary Tract Infection Caused By Community-acquired Extended-spectrum Β-lactamase-producing Bacteria in Infants. J Pediatr (Rio J). 2017;93(3):260-266. PubMed PMID: 27842212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urinary tract infection caused by community-acquired extended-spectrum β-lactamase-producing bacteria in infants. AU - Kim,Yun Hee, AU - Yang,Eun Mi, AU - Kim,Chan Jong, Y1 - 2016/11/11/ PY - 2016/02/12/received PY - 2016/06/22/revised PY - 2016/06/22/accepted PY - 2016/11/15/pubmed PY - 2017/10/5/medline PY - 2016/11/15/entrez KW - Antimicrobial resistance KW - Fatores de risco KW - Infant KW - Infecção do trato urinário KW - Neonato KW - Resistência antimicrobiana KW - Risk factors KW - Urinary tract infection KW - β-Lactamase SP - 260 EP - 266 JF - Jornal de pediatria JO - J Pediatr (Rio J) VL - 93 IS - 3 N2 - OBJECTIVE: Urinary tract infection (UTI) caused by resistant strains of bacteria is increasingly prevalent in children. The aim of this study was to investigate the clinical characteristics and risk factors for UTI caused by community-acquired extended-spectrum β-lactamase (CA-ESBL)-producing bacteria in infants. METHODS: This was a retrospective study performed over 5 years in a single Korean center. Hospitalized infants with febrile UTI were enrolled and divided into two groups (CA-ESBL vs. CA non-ESBL UTI). The yearly prevalence was calculated. Baseline characteristics and clinical course such as fever duration, laboratory and radiological findings were compared between the two groups. Risk factors associated with the CA-ESBL UTI were investigated. RESULTS: Among the enrolled infants (n=185), 31 (17%) had CA-ESBL UTI. The yearly prevalence of ESBL of CA-ESBL UTI increased during the study (0% in 2010, 22.2% in 2015). Infants with CA-ESBL UTI had a longer duration of fever after initiating antibiotics (2.0±1.1 vs. 1.5±0.6 days, p=0.020). Cortical defects on renal scan and early treatment failure were more frequent in CA-ESBL (64.5 vs. 42.2%, p=0.023; 22.6 vs. 4.5%, p=0.001). A logistic regression analysis revealed that urinary tract abnormalities and previous UTI were independent risk factors for CA-EBSL UTI (odds ratio, 2.7; p=0.025; 10.3; p=0.022). CONCLUSION: The incidence of UTI caused by ESBL-producing bacteria has increased in Korean infants. Recognition of the clinical course and risk factors for ESLB-producing UTI may help to determine appropriate guidelines for its management. SN - 1678-4782 UR - https://www.unboundmedicine.com/medline/citation/27842212/Urinary_tract_infection_caused_by_community_acquired_extended_spectrum_β_lactamase_producing_bacteria_in_infants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-7557(16)30260-1 DB - PRIME DP - Unbound Medicine ER -