Related Experiment Video
Updated: Apr 6, 2026
Establishment and Characterization of UTI and CAUTI in a Mouse Model
Published on: June 23, 2015
Emergence of antimicrobial-resistant uropathogens isolated from pediatric patients with cystitis on daily clean
Yoshiki Hiyama1, Satoshi Takahashi1, Teruhisa Uehara1
1Department of Urology, Hokkaido Medical Center for Child Health and Rehabilitation, 1-240-6, kanayama 1-jo, Teine-ku, Sapporo, 006-0041, Japan.
Insights
Pediatric urinary tract infections (UTIs) from clean intermittent catheterization (CIC) can involve resistant bacteria like extended-spectrum β-lactamase (ESBL)-producing E. coli. Healthcare providers should monitor antimicrobial susceptibility in these vulnerable patients.
Area of Science:
- Pediatric infectious diseases
- Urology
- Microbiology
Background:
- Urinary tract infections (UTIs) are a common complication of clean intermittent catheterization (CIC).
- Antimicrobial-resistant pathogens are increasingly reported in adult UTIs, but data in pediatric CIC patients are limited.
Purpose of the Study:
- To investigate the prevalence and types of antimicrobial-resistant bacteria causing cystitis in pediatric patients undergoing CIC for neurogenic bladder dysfunction.
Main Methods:
- Retrospective review of medical charts for 45 pediatric patients with CIC from January 2010 to March 2013.
- Analysis of bacterial strains isolated from urine samples during 62 episodes of cystitis.
Main Results:
- Gram-negative bacteria accounted for 84.3% of isolated strains.
- Six extended-spectrum β-lactamase (ESBL)-producing Escherichia coli strains were identified in 4 patients.
- One ESBL-producing Proteus mirabilis and one methicillin-resistant Staphylococcus aureus strain were also isolated.
Conclusions:
- Gram-negative bacilli, particularly E. coli, are the primary pathogens causing cystitis in pediatric CIC patients.
- ESBL-producing E. coli should be recognized as potential pathogens in this population.
- Regular surveillance of antimicrobial susceptibility is crucial for managing resistant strains.
Abstract:
One of the major complications of clean intermittent catheterization (CIC) is urinary tract infection (UTI). Recent reports showed that community-acquired UTIs caused by antimicrobial-resistant pathogens were gradually presenting in adults. However, there have been few reports about UTIs caused by antimicrobial-resistant bacteria in pediatric patients. Therefore, we retrospectively reviewed the medical charts of 45 children with CIC due to neurogenic bladder dysfunction from January 2010 to March 2013. Sixty-two episodes of cystitis occurred in 27 patients. Seventy bacterial strains were isolated from urine samples. The rate of Gram-negative bacteria was 84.3%. Six extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) strains were isolated from 4 patients. An ESBL-producing Proteus mirabilis strain and a methicillin-resistant Staphylococcus aureus strain were isolated from one patient each. Most of the pathogens of cystitis in the pediatric patients with CIC were Gram-negative bacilli, especially E. coli. We should be aware that ESBL producing E. coli as potential pathogens cause cystitis and regularly survey antimicrobial susceptibility to understand the resistant strains that develop.
Related Concept Videos
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:28Microbiota of the Urogenital Tract
01:25Urinary Tract Infection II: Pathophysiology
01:17Urinary Tract Infection IV: Nursing Management
01:26Urinary Tract Infection I: Introduction