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Community-acquired enterococcal urinary tract infections.
Maria Bitsori1, Sofia Maraki, Maria Raissaki
1Department of Pediatrics, Infectious Diseases Unit, University Hospital of Heraklion, University of Crete, POB 2208, 71003 Heraklion, Greece.
Pediatric Nephrology (Berlin, Germany)
|June 23, 2005
Summary
Community-acquired enterococcal urinary tract infections (UTIs) in children often indicate underlying urinary tract abnormalities. While not an independent risk factor for poor outcomes, these infections signal potential complications like renal scarring and the need for surgery.
Area of Science:
- Pediatrics
- Infectious Diseases
- Urology
Background:
- Enterococcal urinary tract infections (UTIs) are typically hospital-acquired.
- This study focuses on community-acquired enterococcal UTIs in healthy children.
Purpose of the Study:
- To evaluate community-acquired enterococcal UTIs in otherwise healthy children.
- To assess the association between enterococcal UTIs and urinary tract abnormalities or adverse outcomes.
Main Methods:
- Retrospective review of 257 first UTI episodes in hospitalized children over 5 years.
- Analysis of Enterococcus faecalis isolates, susceptibility patterns, and associated imaging studies.
- Comparison of outcomes in children with enterococcal UTIs versus those with Gram-negative UTIs.
Main Results:
- Enterococcus faecalis accounted for 5.1% of UTIs, with all strains susceptible to ampicillin, vancomycin, and nitrofurantoin.
- Children with enterococcal UTIs showed higher rates of major urinary tract abnormalities (34.6%) and parenchymal defects (30.8%).
- Outcomes included breakthrough infections (15.4%), renal scarring (11.5%), and need for surgery (15.4%).
Conclusions:
- Enterococcal UTIs in children are strongly associated with underlying urinary tract abnormalities.
- Enterococcal infection is not an independent risk factor for poor prognosis.
- Positive urine cultures for enterococci warrant thorough investigation for anatomical defects and potential complications.