Urinary tract infection in infants caused by extended-spectrum beta-lactamase-producing Escherichia coli: comparison between urban and rural hospitals

Cheng, Ming‐Fang; Chen, Wan-Ling; Huang, I-Shen; Chen, Jung–Ren; Chiou, Yee-Hsuan; Chen, Yao-Shen; Lee, Susan Shin-Jung; Hung, Wan-Yu; Hung, Cheng‐Chieh; Wang, Jiun‐Ling

doi:10.1007/s00467-016-3338-0

Cited by 17 publications

(16 citation statements)

References 33 publications

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“…Worryingly, the incidence of ESBL-EC continues to increase worldwide (Khanfar et al, 2009;Shakya et al, 2017). This situation leads to longer hospital stays, a dramatic increase in the consumption of antibiotics and consequently higher hospital expenses, and a trend toward higher mortality (Degnan et al, 2015;Cheng et al, 2016;Fernando et al, 2017). The beta-lactam antibiotics, in particular carbapenems, have been widely regarded as the treatment of choice for ESBL-EC infections (Nepal et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance Pattern of Extended Spectrum Beta Lactamase Producing Escherichia coli Isolated From Patients With Urinary Tract Infection in Morocco

Kettani-Halabi

Lahlou

Diawara

et al. 2021

Front. Cell. Infect. Microbiol.

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Extended-spectrum β-lactamases producing Escherichia coli (ESBL-EC) lend resistance to most β-lactam antibiotics. Because of limited treatment options, ESBL-EC infections are generally more difficult to treat, leading to higher hospital costs, reduced rates of microbiological and clinical responses, and a threat to the patient’s life. This study aimed to determine the antibiotic resistance pattern of ESBL-EC isolated from patients with urinary tract infection in Morocco. This retrospective laboratory-based study was conducted at Cheikh Khalifa International University Hospital, Casablanca, from January 2016 to June 2019. A total of 670 urine samples were collected from urinary tract infection patients and processed by standard microbiological methods. In vitro susceptibility testing to different antibiotics of all identified isolates of Escherichia coli (E. coli) was performed following Kirby–Bauer’s disc diffusion method on Mueller–Hinton Agar according to the EUCAST standards. The reviewing of ESBL-EC was confirmed by the appearance of a characteristically shaped zone referred to as a “champagne cork” using the Combined Disk Test. Among a total of 438 E. coli isolated from nonrepetitive urine samples, two hundred fifty-nine (59%) were ESBL-EC, of which 200 (77%) were isolated from adult patients (over the age of 50) and the majority were female. All ESBL-EC isolates were resistant to third-generation cephalosporin and quinolones and sensitive to carbapenem and fosfomycin. Knowledge of antimicrobial resistance patterns in ESBL-EC, the major pathogen associated with urinary tract infection, is indispensable as a guide in choosing empirical antimicrobial treatment.

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Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance Pattern of Extended Spectrum Beta Lactamase Producing Escherichia coli Isolated From Patients With Urinary Tract Infection in Morocco

Kettani-Halabi

Lahlou

Diawara

et al. 2021

Front. Cell. Infect. Microbiol.

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“…ESBLproducing organisms were typically limited to heal thcare facilities, but they have begun to appear in com munities as well, and their prevalence is consistently in creasing, as is the severity of infection 1,9,11) . Consequently, it is important to recognize the risk factors for ESBLpro ducing organisms.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Extended-spectrum β-lactamase-producing Bacteria in First Pediatric Febrile Urinary Tract Infections and Differences between Age Groups

Park

Kim

2017

Child Kidney Dis

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Extended-spectrum β-lactamase-producing bacteria-induced urinary tract infections are increasing and require more potent antibiotics such as carbapenems. We evaluated the clinical significance of extended-spectrum β-lactamase urinary tract infection in children younger than 5 years to select proper antibiotics and determine prognostic factors. Differences were compared between age groups. Methods: We retrospectively studied 288 patients with their first febrile urinary tract infection when they were younger than 5 years. Patients were divided into extended-spectrum β-lactamase-positive and extended-spectrum β-lactamasenegative urinary tract infection groups. Clinical characteristics and outcomes were compared between the groups; an infant group was separately analyzed (onset age younger than 3 months). Results: Extended-spectrum β-lactamase urinary tract infection occurred in 11 % patients who had more frequent previous hospitalization (P=0.02) and higher recurrence rate (P=0.045). During the antimicrobial susceptibility test, the extendedspectrum β-lactamase-positive urinary tract infection group showed resistance to third-generation cephalosporins; however, 98% patients responded clinically. In the infant group, extended-spectrum β-lactamase-positive urinary tract infection occurred in 13% patients and was associated with a longer pre-onset hospitalization history (P=0.002), higher C-reactive protein level (P=0.04), and higher recurrence rate (P=0.02) than that in the older group. Conclusion: Extended-spectrum β-lactamase urinary tract infection requires more attention because of its higher recurrence rate. The antimicrobial susceptibility test demonstrated resistance to third-generation cephalosporins, but they can be used as first-line empirical antibiotics because of their high clinical response rate. Aminoglycosides can be second-line antibiotics before starting carbapenems when third-generation cephalosporins do not show bactericidal effects for extended-spectrum β-lactamase urinary tract infection.

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“…Анализ данных проведен с использованием пакета статистических программ STATISTICA v. 10.0 (StatSoft Inc., США). Сравнение качественных показателей в несвязанных выборках проводилось с использованием точного кри-терия Фишера, если в одной из ячеек таблицы 2ϫ2 число наблюдений было менее 5, критерия 2 с поправкой Йейтса -в остальных случаях таблиц 2ϫ2, только критерия 2 она выделялась в 60-90% случаев [22,23], при хроническом -р 56% [24]. Высеваемость Proteus spp.…”

Section: методы статистического анализа данныхunclassified

Changes in Urine Microflora in Children With Community-Acquired Urinary Tract Infection Admitted to Hospital Between 1990 and 2015: A Retrospective Full-Design Study of Case Series

Zhdanova¹,

Настаушева²,

Гребенникова³

et al. 2018

Vopr. sovr. pediatr.

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Background. It is necessary to study the microbial spectrum of urine in order to determine the features of the urinary tract infection (UTI) course and to make the right choice of a therapeutic approach. Objective. Our aim was to study the structure of urine microflora in children with community-acquired UTI and its change in the period from 1990 to 2015.Methods. We conducted a continuous analysis of case histories of children admitted to hospital with UTI (pyelonephritis, cystitis, non-site specific urinary tract infection) in 1990, 2000, and 2015. We studied the results of triple (in succession) urine cultures. Shedding in a concentration of ≥ 103 cfu/ml for primary pathogens, ≥ 103 cfu/ml in boys and ≥ 104 cfu/ml in girls for secondary pathogens, ≥ 105 cfu/ml for doubtful pathogens considered to be a diagnostically significant one.Results. Members of the family Enterobacteriaceae were the main causative agents of the UTI in 1990 (found in 90.4% of 502 samples), 2000 (in 79.7% of 632 samples), and 2015 (in 67.6% of 801 samples, df = 2, p < 0.001). Escherichia coli remained the most common microorganism, the isolation rate of which decreased from 79.9% in 1990 to 39.5% in 2015 (p < 0.001). In the period from 2000 to 2015, there was a decrease in the frequency of urine detection of Enterobacter spp. (from 5.9 to 2.5%; p < 0.001) and Citrobacter spp. (from 5.2 to 1%; p < 0.001) and, on the contrary, an increase in the isolation rate of Proteus spp. (from 7.8 to 11.7%; p = 0.005), Klebsiella spp. (from 2.8 to 12.9%; p < 0.001) and Enterococcus spp. (from 1.8 to 19.1%; p < 0.001); the latter two — due to more frequent shedding in boys (by 10.5 and 19.9%, respectively).Conclusion. The Enterobacteriaceae members, mainly E. coli and Enterococcus spp., remained the predominant UTI pathogens in children in 1990, 2000, and 2015. The isolation rate of E. coli has declined significantly in recent years, whereas that of Klebsiella spp. and Enterococcus spp. has increased.

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Urinary tract infection in infants caused by extended-spectrum beta-lactamase-producing Escherichia coli: comparison between urban and rural hospitals

Cited by 17 publications

References 33 publications

Antibiotic Resistance Pattern of Extended Spectrum Beta Lactamase Producing Escherichia coli Isolated From Patients With Urinary Tract Infection in Morocco

Antibiotic Resistance Pattern of Extended Spectrum Beta Lactamase Producing Escherichia coli Isolated From Patients With Urinary Tract Infection in Morocco

Clinical Significance of Extended-spectrum β-lactamase-producing Bacteria in First Pediatric Febrile Urinary Tract Infections and Differences between Age Groups

Changes in Urine Microflora in Children With Community-Acquired Urinary Tract Infection Admitted to Hospital Between 1990 and 2015: A Retrospective Full-Design Study of Case Series

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