Pediatrics international : official journal of the Japan Pediatric Society · 2019
Urinary tract infection caused by extended-spectrum β-lactamase-producing bacteria: Risk factors and antibiotic resistance.
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Albaramki Jumana H, Abdelghani Tariq, Dalaeen Alaa, Khdair Ahmad Fareed, Alassaf Abeer, Odeh Rasha, Akl Kamal
Аннотация
BACKGROUND: The aim of this study was to investigate the risk factors for acquisition of extended spectrum β-lactamase (ESBL)-producing bacteria in community-acquired urinary tract infection (UTI) and to evaluate their antimicrobial resistance.
METHODS: The medical records of hospitalized children were retrospectively evaluated. Children with ESBL-producing bacteria UTI were matched with controls with non-ESBL-producing bacteria UTI of the same age and gender.
RESULTS: A total of 243 patients with community-acquired UTI in a 5 year period were evaluated, of whom 46% had UTI caused by ESBL bacteria. Seventy-seven cases were matched with 77 controls. There were no significant differences in the clinical presentation between the two groups apart from a longer hospital stay in the ESBL group (9.1 ± 5.5 days vs 8.0 ± 4.4 days, P = 0.013). Significant potential risk factors for ESBL-UTI were previous use of antibiotics in the last 3 months, previous hospitalization in the last 3 months, history of recurrent UTI, and presence of renal anomalies. On logistic regression analysis, history of previous hospitalization in the last 3 months (OR, 3.83; 95%CI: 1.49-9.84) was identified as an independent significant risk factor for ESBL-UTI. There was a significantly higher resistance to amoxicillin-clavulanate, amikacin, gentamycin and quinolones in the ESBL group compared with the control group.
CONCLUSION: Recognizing the risk factors for ESBL-UTI helps to identify the high-risk cases and enables proper management.
METHODS: The medical records of hospitalized children were retrospectively evaluated. Children with ESBL-producing bacteria UTI were matched with controls with non-ESBL-producing bacteria UTI of the same age and gender.
RESULTS: A total of 243 patients with community-acquired UTI in a 5 year period were evaluated, of whom 46% had UTI caused by ESBL bacteria. Seventy-seven cases were matched with 77 controls. There were no significant differences in the clinical presentation between the two groups apart from a longer hospital stay in the ESBL group (9.1 ± 5.5 days vs 8.0 ± 4.4 days, P = 0.013). Significant potential risk factors for ESBL-UTI were previous use of antibiotics in the last 3 months, previous hospitalization in the last 3 months, history of recurrent UTI, and presence of renal anomalies. On logistic regression analysis, history of previous hospitalization in the last 3 months (OR, 3.83; 95%CI: 1.49-9.84) was identified as an independent significant risk factor for ESBL-UTI. There was a significantly higher resistance to amoxicillin-clavulanate, amikacin, gentamycin and quinolones in the ESBL group compared with the control group.
CONCLUSION: Recognizing the risk factors for ESBL-UTI helps to identify the high-risk cases and enables proper management.
Предметные рубрики MeSH
AdolescentAnti-Bacterial AgentsCase-Control StudiesChildChild, PreschoolCommunity-Acquired InfectionsDrug Resistance, MicrobialEscherichia coliEscherichia coli InfectionsFemaleFollow-Up StudiesHumansIncidenceInfantInfant, NewbornJordanMaleMicrobial Sensitivity TestsRetrospective StudiesRisk AssessmentRisk FactorsUrinary Tract Infectionsbeta-Lactamases