Community-onset extended-spectrum β-lactamase producing Escherichia coli in urinary tract infections in children from 2015 to 2016: Prevalence, risk factors, and resistances

Medicine (Baltimore). 2017 Dec;96(50):e8571. doi: 10.1097/MD.0000000000008571.

Abstract

Over the past 10 years, the resistances among microbes are increasing gradually in Europe and greater resistances are seen in southern countries. We studied the prevalence of community-onset ESBL-producing Escherichia coli urinary tract infections in children.As secondary objectives, we analyzed associated risk factors and the resistance patterns in ESBL-producing E coli isolates.Retrospective observational study in a tertiary care hospital about children ≤14 years old with community-onset E coli urinary tract infection. The variables studied were age, sex, ESBL-producing, antibiotic therapy 7 to 30 days before the infection, hospitalization 7 to 30 days before the infection, nefrourologic pathology, and vesicoureteral reflux.Between January 1st, 2015 and December 31st, 2016, 229 isolates of E coli were obtained, of whom 21 (9.2%) where ESBL-producing E coli. Median age in non-ESBL-producing was 18 months versus 7 months in ESBL-producing group. Fourteen (66%) of the ESBL-producing group were men (P = .001), 5 (23.8%) were hospitalized 30 days before the infection (P = .001), 12 (57.1%) had nefrourological pathology (P = .003), 6 (28.5%) had vesicoureteral reflux (P = .032). Previous antibiotic therapy was not statistically significant. Multiple regression analyses between sex and 30 days previous hospitalization were r = 3.51 (P = .0001). Multidrug resistant isolates among ESBL-producing E coli was 12 (57%).The retrospective study allowed assessing the problem of ESBL-producing isolates in the outpatient settings. Some risk factors from past studies were confirmed and a combined risk is suggested. The resistant spectrum should be taken into account when choosing antibiotic regimens.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Anti-Bacterial Agents / therapeutic use
  • Community-Acquired Infections / epidemiology
  • Drug Resistance, Multiple, Bacterial*
  • Escherichia coli
  • Escherichia coli Infections / drug therapy*
  • Escherichia coli Infections / epidemiology*
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Male
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology*
  • Vesico-Ureteral Reflux / epidemiology
  • beta-Lactamases

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases