Once-daily intramuscular amikacin for outpatient treatment of lower urinary tract infections caused by extended-spectrum &amp;beta;-lactamase-producing &lt;em&gt;Escherichia coli&lt;/em&gt; in children

Polat, Meltem; Kara, Soner Sertan

doi:10.2147/idr.s148703

Cited by 20 publications

(13 citation statements)

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“…A study from Turkey in 53 children aged 3-12 years with amikacin-sensitive ESBL UTI [24] had a 96% response rate with once daily intramuscular amikacin for 6 days (range 3-7 days). Overall, 30% of the children had recurrent UTI, 30% had antibiotic prophylaxis, and 90% were given antibiotics in the last 3 months.…”

Section: Discussionmentioning

confidence: 99%

Extended - spectrum beta - lactamase E. coli and K. pneumoniae urinary tract infections

Vachvanichsanong

McNeil

Dissaneewate

2020

Preprint

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Background: The prevalences of extended - spectrum beta - lactamase (ESBL) Escherichia coli ( E . coli ) and Klebsiella pneumoniae ( K . pneumoniae ) urinary tract infections (UTI) in children are increasing worldwide. We aimed to investigate the prevalence, clinical findings, impact and risk factors of ESBL E . coli / K . pneumoniae UTI.Methods: The medical records of children with UTI aged <15 years admitted to Prince of Songkla University Hospital were reviewed. Results: Theirty-seven boys and 46 girls had ESBL in 102 UTI episodes; 85 boys and 103 girls had non-ESBL in all of their 222 UTI episodes. The median age at presentation was 1.5 (0.7 - 4.8) years for the ESBL group and 1.3 (0.6 - 3.9) for the non-ESBL group (p=0.2). Age 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. The prevalences in first and recurrent UTI were 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, children without fever (OR=2.14, 95% CI: 1.23-3.74) and those with recurrent UTI (OR=2.67, 95% CI: 1.37 – 5.19) were more likely to have ESBL UTI. The presence of CAKUT had no effect on ESBL UTI. Conclusions: ESBL was found in one-third of E . coli / K . pneumoniae UTI episodes. No clinical condition nor imaging study could predict ESBL. Recurrent UTI was the only independent risk factor.

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Section: Discussionmentioning

confidence: 99%

Extended - spectrum beta - lactamase E. coli and K. pneumoniae urinary tract infections

Vachvanichsanong

McNeil

Dissaneewate

2020

Preprint

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“…44 Um estudo retrospetivo realizado de 2015 a 2016, que incluiu crianças dos dois aos 18 anos com cistites causadas por estirpes de E. coli produtoras de ESBL-AC, concluiu que a cura clínica ocorreu em 96% (n = 51/53) dos casos. 45 Uma análise retrospetiva realizada na Coreia do Sul, verificou que não existiam diferenças estatisticamente significativas entre as crianças com IU por Enterobacteriaceae produtoras de ESBL tratadas com antibióticos não-carbapenemos (cefotaxima, piperacilina-tazobactan e amicacina) e com carbapenemos. 40 No nosso estudo, a cura clínica ocorreu em 91% (n = 30/33) dos casos com terapêutica empírica inicial com cefuroxime-axetil (56%) ou amoxicilina/ácido clavulânico (46%).…”

Section: Discussionunclassified

Infeções Urinárias Causadas por Enterobacteriaceae Produtoras de β-Lactamases de Espetro Expandido Adquiridas na Comunidade num Hospital de Nível III - Um Estudo Retrospetivo

et al. 2020

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Introduction: The emergence of β-lactamases producing bacteria is a problem worldwide, with increasing importance in communityacquired infections, especially in urinary tract infections. Data regarding the use of non-carbapenem antimicrobials in these infections are scarce. The aim of this study was to analyse the treatment and outcome of urinary tract infections caused by community-acquired β-lactamase-producing bacteria in children.Material and Methods: Retrospective study performed in a level III paediatric hospital, between June 2007 and December 2017. All children with β-lactamase-producing Enterobacteriaceae identified in aseptically collected urine culture were included.Results: A total of 175 urinary infections caused by β-lactamases producing bacteria were diagnosed, 34 (19%) were community-acquired: 25 Escherichia coli (74%), 4 Klebsiella pneumoniae (12%), 4 Proteus mirabilis (12%) and 1 Proteus vulgaris (3%). In 30 (88%) cases, it was the first urinary infection. After identification of the microorganism and antimicrobial susceptibility, 33 (97%) children were re-evaluated and 24 (71%) had a repeat urine culture, which was positive in three (13%). In six (18%) cases, antibiotic treatment was modified. Four (12%) children had another UTI in the following month. In 30 (88%) children, imaging was carried out, with no nephrourological malformations detected.Discussion: In the last decade, about 20% of urinary infections caused by β-lactamase-producing Enterobacteriaceae were community-acquired with a relatively stable number of cases over the years. No nephro-urological malformations were identified in these children.Conclusion: Although the number of cases is small, the clinical and microbiological outcomes showed that most were successfully treated with non-carbapenem antibiotics, with low recurrence of new episodes of urinary tract infections.

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“…In a recent study, Polat and Kara proved the usefulness of once-daily intramuscular Amikacin in children with lower UTIs caused by ESBL-producing E. coli strains susceptible to this drug, without any oral therapy option, treated as outpatients (15).…”

Section: Discussionmentioning

confidence: 99%

New Insights in Treatment Options in Pediatric Urinary Tract Infection

Duicu

Armean²,

Aldea

2019

Acta Medica Marisiensis

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Urinary tract infection (UTI) represents one of the most frequent infections with bacterial etiology during childhood. In infants and toddlers with fever without source UTI’ investigation should be carried out, since signs and symptoms are nonspecific. However, obtaining uncontaminated urine samples from these patients can be challenging and time consuming; all current collection methods (clean-catch, plastic collection bag, catheterization, etc) have disadvantages. Criteria for UTI definition are represented by the presence of significant number of a single uropathogen, this number being different depending on the collection method: at least 1000 colony-forming unit (CFU/ml) for catheter samples and at least 100.000 CFU/ml from midstream clean-catch samples or 50.000 CFU/ml and significant pyuria in a symptomatic or febrile child. Accurate diagnosis of UTI is essential to avoid any antibiotic overuse and expensive investigations. UTI caused by resistant bacterial strains has an increasing prevalence in children. In pediatric population, extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBLPE) represent the etiology of around 15% of UTIs. Because of limited therapeutic options the reintroduction of some old antimicrobial agents is necessary, therefore Nitrofurantoin and Fosfomycin, can represent alternatives for oral treatment and prophylaxis of UTIs in children or in case of resistance suspicion to other drug classes. It is important to recognize patients at risk, such as children with recurrent UTIs, kidney abnormalities, like vesicoureteral reflux and previous antibiotherapy, in order to recommend adequate empiric treatment, especially against resistant bacteria.

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Once-daily intramuscular amikacin for outpatient treatment of lower urinary tract infections caused by extended-spectrum β-lactamase-producing <em>Escherichia coli</em> in children

Cited by 20 publications

References 25 publications

Extended - spectrum beta - lactamase E. coli and K. pneumoniae urinary tract infections

Extended - spectrum beta - lactamase E. coli and K. pneumoniae urinary tract infections

Infeções Urinárias Causadas por Enterobacteriaceae Produtoras de β-Lactamases de Espetro Expandido Adquiridas na Comunidade num Hospital de Nível III - Um Estudo Retrospetivo

New Insights in Treatment Options in Pediatric Urinary Tract Infection

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