Nosocomial urinary tract infections at a pediatric hospital

Davies, H. Dele; Jones, Elizabeth; Sheng, Ruanmei; Leslie, Bruno; Matlow, Anne; Gold, R

doi:10.1097/00006454-199205000-00002

Cited by 64 publications

(19 citation statements)

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“…Enterococcal UTI in children is more often of nosocomial origin than community acquired, with frequencies of 12-15% and 4.4-5.6% of the total UTI episodes, respectively [5,6,12,13]. E. faecalis is the predominant species (14), and was the single Enterococcus species isolated in this study.…”

Section: Discussionmentioning

confidence: 62%

“…Enterococci as childhood uropathogens have been mostly studied in nosocomial UTIs, in children with urinary tract malformations, and in children on prophylaxis [5,6,7,8], but not in the general population. In this study we investigated the frequency, clinical characteristics, susceptibility patterns, imaging findings and long-term outcome of children with community-acquired enterococcal UTI.…”

Section: Introductionmentioning

confidence: 99%

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Community-acquired enterococcal urinary tract infections

et al. 2005

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Enterococcal urinary tract infection (UTI) is usually hospital-acquired and affects individuals with predisposing conditions. The aim of this study was to evaluate the community-acquired enterococcal UTIs in otherwise well children. We reviewed all the 257 first UTI episodes in children hospitalized in a General Hospital during a 5-year period. Enterococcus faecalis was isolated in 13 episodes, accounting for 5.1% of the total UTIs. All strains were susceptible to ampicillin, vancomycin and nitrofurantoin. Imaging studies revealed major urinary tract abnormalities in 9 and parenchymal defects in 8 children. During a follow-up period from 2 to 6 years, 4 children suffered break-through infections despite antibiotic prophylaxis, 3 developed renal scarring and 4 underwent corrective surgical procedures. Children with enterococcal UTIs presented with significantly higher rates of anatomical abnormalities and worse prognosis in terms of renal scarring, recurrences and corrective surgery compared with the total cohort of children with Gram-negative UTIs. However children with enterococcal UTIs did not present with a worse prognosis when compared with a group of children with Gram-negative UTIs matched for age and degree of reflux. Enterococcal infection is not an independent risk factor for poor outcome, nevertheless positive urine culture including enterococci is highly indicative for underlying urinary tract abnormalities, recurrences, renal scarring, and need for surgical intervention.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Community-acquired enterococcal urinary tract infections

et al. 2005

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“…Of the less common Gram-positive pediatric uropathogens, the main genus is Enterococcus, predominantly the species Enterococcus faecalis [10]. However, research on enterococcal UTIs in children is very limited, with most studies dealing with nosocomial infections [21][22][23][24]. Due to its unique antimicrobial susceptibility profile, Enterococcus spp.…”

Section: Introductionmentioning

confidence: 99%

Community-acquired enterococcal urinary tract infections in hospitalized children

et al. 2011

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The objectives of this study were to characterize community-acquired (CA) enterococcal urinary tract infections (UTIs) in a tertiary pediatric center and to determine risk factors for their occurrence, their association with renal abnormalities, their antibiotic susceptibility profile, and the appropriateness of the empiric antibiotic treatment, in comparison to those of Gram-negative UTIs. In a 5-year prospective clinical and laboratory study, we found that enterococcal UTIs caused 6.2% (22/355) of culture-proven CA UTIs. Compared with Gram-negative UTI, enterococcal UTI was associated with male predominance, higher rates of underlying urinary abnormalities (70 vs. 43.7%; p = 0.03) and inappropriate empiric antibiotic therapy (22 vs. 5.6%; p = 0.02), and mainly vesicoureteral reflux (53% of cases). This study highlights the importance of early detection of CA enterococcal UTIs because of their association with underlying urinary abnormalities and a high rate of inappropriate empiric antibiotic therapy. Renal imaging is recommended for children with enterococcal UTIs; Gram stain is suggested in selected cases to detect Gram-positive cocci for early diagnosis of enterococcal UTIs and initiation of appropriate antibiotics.

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“…14 The microbial pattern of neonatal UTI has changed from that observed in the 1970s compared to that of the 1990s. 18 reported that in Charlottesville and Toronto, the most common pathogens of neonatal UTI were coagulase-negative Staphylococcus, Candida sp. and Klebsiella sp.…”

Section: Discussionmentioning

confidence: 99%

Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital

Amelia¹,

Amir²,

Trihono³

2016

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, MD, MM(Paed) association with neonatal sepsis. It is often difficult to identify whether UTI was the cause or the effect of bacteremia. 1-3 The prevalence of UTI among late-onset sepsis neonates in developed countries varies from 7.4 to 25.3%, with higher rates in preterm infants. [4][5][6][7][8] UTI at very young age has the potential for lifelong morbidity. Progressive renal damage in early childhood may lead to hypertension and chronic renal failure later in life. 2,9 The clinical manifestations of UTI in the neonatal period may vary and are nonspecific, as well as the sepsis itself. 1-3,10 Urinalysis and urine culture as well as lumbar puncture for late-onset neonatal sepsis are part of a full septic-work up, 10 but are not routinely done in our neonatal ward. It is important to recognize whether there is pyelonephritis in a neonate who shows clinical signs of sepsis in order to provide appropriate treatment. However, proper procedures in obtaining urine samples for culture are invasive and have potential risks for trauma and infection. 2,9 The objective of our study was to define the prevalence and microbiological pattern of UTI among neonates with late-onset sepsis in the neonatal ward of Cipto Mangunkusumo Hospital.T he urinary tract is a common site of infection in infants and young children. 1 Urinary tract infection (UTI) in neonates often occur in ABSTRACTBackground Urine culture, as part of a full septic work-up for

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Nosocomial urinary tract infections at a pediatric hospital

Cited by 64 publications

References 0 publications

Community-acquired enterococcal urinary tract infections

Community-acquired enterococcal urinary tract infections

Community-acquired enterococcal urinary tract infections in hospitalized children

Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital

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