Epidemiological profile and risk factors of community-acquired caused by enterobacteria strains producing ESBL urinary tract infections in Tunisian children.

INTRODUCTION

The rise in community-acquired urinary tract infections (UTI) caused by enterobacteria strains producing extended spectrum beta-lactamase (ESBL) in children has complicated treatment strategies.

OBJECTIVE

This study aimed to evaluate risk factors associated with ESBL-producing UTIs in pediatric patients and analyze the antibiotic resistance patterns of the causative pathogens.

METHODS

A six-year cross-sectional study (January 2019-December 2024) was conducted at Sahloul University Hospital's pediatric department, including children under 15 years hospitalized with community-acquired UTIs.

RESULTS

A total of 383 UTI were included with 20.4% of UTI caused by ESBL producing strains. Females represented 62.66% (sex ratio=0.59). The median patient age was 11 months [3-66]. Escherichia coli and Klebsiella pneumoniae were the most common isolates (80.4% and 12.27%). Common risk factors included prior antibiotic use (41%), hospitalization in the past year (30.81%), recurrent UTIs (20.89%), and the presence of malformative uropathy (8.62%). Multivariate analysis confirmed only prior hospitalization (≤12 months) as an independent factor with ESBL strains (p = 0.005).

CONCLUSION

The increasing prevalence of ESBL-related UTIs in children calls for stricter antibiotic stewardship and ongoing surveillance of resistance trends in this population.