Extended-spectrum beta-lactamase Escherichia coli and Klebsiella pneumoniae urinary tract infections

Abstract

The prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae urinary tract infections (UTIs) is increasing worldwide. We investigated the prevalence, clinical findings, impact and risk factors of ESBL E. coli/K. pneumoniae UTI through a retrospective review of the medical records of children with UTI aged <15 years admitted to Prince of Songkla University Hospital, Thailand over 10 years (2004–2013). Thirty-seven boys and 46 girls had ESBL-positive isolates in 102 UTI episodes, compared with 85 boys and 103 girls with non-ESBL isolates in 222 UTI episodes. The age of presentation and gender were not significantly different between the two groups. The prevalence of ESBL rose between 2004 and 2008 before plateauing at around 30–40% per year, with a significant difference between first and recurrent UTI episodes of 27.3% and 46.5%, respectively (P = 0.003). Fever prior to UTI diagnosis was found in 78.4% of episodes in the non-ESBL group and 61.8% of episodes in the ESBL group (P = 0.003). Multivariate analysis indicated that children without fever (odds ratio (OR) 2.14, 95% confidence interval (CI) 1.23–3.74) and those with recurrent UTI (OR 2.67, 95% CI 1.37–5.19) were more likely to yield ESBL on culture. Congenital anomalies of the kidney and urinary tract were not linked to the presence of ESBL UTI. In conclusion, ESBL producers represented one-third of E. coli/K. pneumoniae UTI episodes but neither clinical condition nor imaging studies were predictive of ESBL infections. Recurrent UTI was the sole independent risk factor identified.

A Clinical Prediction Tool for Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Urinary Tract Infection

“…In a study of antimicrobial resistance trends from 2010 to 2013, ESBL-PE was frequently detected in China and Southeast Asia, and the ESBL production rate of E. coli and K. pneumoniae in some Asian countries was as high as 60% [9]. A study by Vachvanichsanong estimated that ESBL-PE represented one-third of all E. coli and K. pneumoniae UTI episodes [11]. Data from the CHINET antimicrobial resistance monitoring project shows that the detection rate of ESBL-producing E. coli in China rose from 38.9% in 2005 to 55.8% in 2014, with similar rises in other countries [10].…”

Antagonistic effect of Bacillus subtilis isolated and identified from different honey species against Klebsiella pneumoniae bee pathogens

“…We describe the isolation and identification of Bacillus subtilis bacteria isolated from different honey species and their antagonistic effect on Klebsiella pneumoniae. This type of enterobacteria causes damage to the intestinal enterocytes of bees (Rozhenkov et al, 2017), alveoli of the lungs, nephrons, and tubules of the kidneys of animals and humans (Vachvanichsanong et al, 2021). Frequent and long-term use of antibiotic therapy has led to significant resistance of these microorganisms, characterized by the presence of genes that encode the ability to synthesize carbapenemases (Polischouk et al, 2017;Bozhkova et al, 2020;Nevezhina, 2021).…”

Analysis of antibiotic resistance and virulence patterns inKlebsiella pneumoniaeisolated from human urinary tract infections in India

“…ESBL-producing K. pneumoniae causing UTI in children and adults is a serious concern worldwide which progresses to sepsis and prolonged hospitalizations. Isolation of ESBL-producing K. pneumoniae severely limits therapeutic options and the treatment are often delayed due to antibiotic susceptibility testing (Vachvanichsanong et al 2021). ESBL-producing strains of K. pneumoniae are widespread across the world causing numerous outbreaks (Tumbarello et al 2006).…”