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06:09

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis

Published on: July 18, 2017

Treatment of pyelonephritis caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in children

Tomohiro Katsuta1, Kensuke Shoji, Yasushi Watanabe

  • 1Department of Pediatrics, Division of Infectious Diseases, St. Marianna University School of Medicine, Kanagawa, Japan.

The Pediatric Infectious Disease Journal
|January 1, 2013
PubMed

Insights

Pyelonephritis in children caused by extended-spectrum β-lactamase-producing Enterobacteriaceae can be effectively treated with noncarbapenem antimicrobials, even with initial ineffective treatments. Most children recovered quickly with excellent clinical outcomes.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Resistance
  • Clinical Microbiology

Background:

  • Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae pose a significant challenge in pediatric infections.
  • Pyelonephritis is a common and serious urinary tract infection in children.
  • Accurate diagnosis and appropriate antimicrobial selection are crucial for favorable outcomes.

Purpose of the Study:

  • To evaluate the clinical outcomes of pediatric pyelonephritis caused by ESBL-producing Enterobacteriaceae.
  • To assess the efficacy of noncarbapenem antimicrobials in treating these infections.
  • To determine if initial inappropriate antimicrobial therapy impacts patient recovery.

Main Methods:

  • Retrospective analysis of 54 pediatric patients diagnosed with pyelonephritis due to ESBL-producing Enterobacteriaceae.
  • Review of patient data including demographics, causative organisms, antimicrobial treatments, and clinical outcomes.
  • Assessment of time to fever resolution and overall clinical recovery.

Main Results:

  • Despite 59% of patients initially receiving ineffective antimicrobials, 72% became afebrile within 2 days.
  • Excellent clinical outcomes were observed in the majority of children treated.
  • Noncarbapenem antimicrobials demonstrated successful treatment in this cohort.

Conclusions:

  • Pediatric pyelonephritis caused by ESBL-producing Enterobacteriaceae can be successfully managed with noncarbapenem antimicrobials.
  • Prompt clinical improvement is achievable even with initial suboptimal antimicrobial therapy.
  • This finding supports the judicious use of noncarbapenem agents, reserving carbapenems when necessary.

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