J Korean Soc Pediatr Nephrol.  2012 Apr;16(1):38-45.

Clinical Significance of Extended-Spectrum beta-Lactamase Producing Escherichia coli in Pediatric Patients with Febrile Urinary Tract Infection

• Park C
• Kim MS
• Kim MK
• Yim HE
• Yoo KH
• Hong YS
• Lee JW

Abstract

PURPOSE
The incidence of community-acquired urinary tract infection (UTI) due to extended-spectrum beta-lactamase producing Escherichia coli (ESBL(+) E. coli) has increased worldwide. ESBL causes resistance to various types of the newer beta-lactam antibiotics, including the expanded spectrum cephalosporins and monobactams. We aimed to investigate the severity of UTI and associated genitourinary malformations in children with febrile UTI caused by ESBL(+) E. coli.
METHODS
We retrospectively reviewed the medical records of 290 patients diagnosed as febrile UTI caused by E. coli between January 2008 and October 2010 at Korea University Medical center. We classified the patients into two groups with ESBL(+) and ESBL(-) E. coli group according to the sensitivity of urine culture. Fever duration, admission period, white blood cell (WBC) counts and C-reactive protein (CRP) in peripheral blood, the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR) and renal scar were compared between the two groups.
RESULTS
Patients with ESBL(+) E. coli were 32, and those with ESBL(-) E. coli were 258. If we excluded those tested with a sterile urine bag, patients with ESBL(+) E. coli were 22, and those with ESBL(-) E. coli were 212. Whether the results of sterile urine bag tests were included or not, there was no significant difference in all parameters between the two groups statistically.
CONCLUSION
Our data shows that ESBL(+) E. coli may not be related to the severity of UTI and associated genitourinary malformations.

Keyword

Extended-spectrum beta-lactamase; Escherichia coli; Urinary tract infection

MeSH Terms

Academic Medical Centers
Anti-Bacterial Agents
beta-Lactamases
C-Reactive Protein
Cephalosporins
Child
Cicatrix
Escherichia
Escherichia coli
Fever
Humans
Hydronephrosis
Incidence
Korea
Leukocytes
Medical Records
Monobactams
Retrospective Studies
Urinary Tract
Urinary Tract Infections
Vesico-Ureteral Reflux
Anti-Bacterial Agents
C-Reactive Protein
Cephalosporins
Monobactams
beta-Lactamases