Pediatr Infect Vaccine.  2015 Apr;22(1):29-35. 10.14776/piv.2015.22.1.29.

Febrile Urinary Tract Infections Caused by Community-Acquired Extended-Spectrum beta-Lactamase-Producing and-Nonproducing Bacteria: A Comparative Study

• Ahn DH
• Kim KW
• Cho HK
• Tchah H
• Jeon IS
• Ryoo E
• Sun YH

• KMID: 1791514
• DOI: http://doi.org/10.14776/piv.2015.22.1.29

Abstract

PURPOSE
The purpose of this study was to investigate the clinical characteristics and outcome of febrile urinary tract infections (UTIs) caused by community-acquired extended-spectrum beta-lactamase (CA-ESBL)-producing and -nonproducing bacteria.
METHODS
We analyzed febrile UTIs in children hospitalized at Gachon University Gil Medical Center from January 2011 to December 2013 through retrospective data collection from their medical records.
RESULTS
Among pathogens causing 374 episodes of UTIs, the proportion of ESBL-producing bacteria was 13.1% (49/374). The proportion of ESBL-producing Escherichia coli and Klebsiella spp. was 13.6% (48/354) and 5.0% (1/20), respectively. There was no significant difference between the CA-ESBL and CA non-ESBL groups in duration of fever (4.2+/-2.7 vs.3.7+/-2.1 days, P=0.10) and bacterial eradication rate with empirical antibiotics (100% vs. 100%). The risk of cortical defects on renal scan significantly depended on existence of vesicoureteral reflux rather than ESBL production of pathogen.
CONCLUSIONS
There was no significant difference between the CA-ESBL and CA non-ESBL groups in renal cortical defects and clinical outcome. Careful choice of antibiotics is important for treatment of community-acquired UTI in children.

Keyword

Urinary tract infection; Extended-spectrum beta-lactamase

MeSH Terms

Anti-Bacterial Agents
Bacteria*
beta-Lactamases
Child
Data Collection
Escherichia coli
Fever
Humans
Klebsiella
Medical Records
Retrospective Studies
Urinary Tract Infections*
Vesico-Ureteral Reflux
Anti-Bacterial Agents
beta-Lactamases

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