Urinary tract infection caused by community-acquired extended-spectrum β-lactamase-producing bacteria in infants

Area of Science:

• Pediatrics
• Infectious Diseases
• Microbiology

Background:

• Urinary tract infections (UTIs) in infants are a common concern.
• Increasing prevalence of antibiotic-resistant bacteria, such as extended-spectrum β-lactamase (ESBL)-producing strains, complicates pediatric UTI management.
• Community-acquired ESBL-producing bacteria pose a growing threat in pediatric healthcare settings.

Purpose of the Study:

• To investigate the clinical characteristics of UTIs caused by community-acquired ESBL-producing bacteria in infants.
• To identify risk factors associated with CA-ESBL-producing bacterial UTIs in this population.
• To understand the evolving prevalence of CA-ESBL UTIs in Korean infants.

Main Methods:

• Retrospective study conducted over 5 years at a single Korean center.
• Inclusion of hospitalized infants diagnosed with febrile UTI.
• Comparison of clinical characteristics, fever duration, laboratory findings, and radiological results between CA-ESBL and CA non-ESBL UTI groups.

Main Results:

• CA-ESBL UTIs were diagnosed in 17% of enrolled infants (n=185).
• Yearly prevalence of ESBL-producing bacteria increased from 0% in 2010 to 22.2% in 2015.
• Infants with CA-ESBL UTI experienced longer fever duration, higher rates of cortical defects on renal scans, and more frequent early treatment failure.
• Urinary tract abnormalities and prior UTI were identified as independent risk factors for CA-ESBL UTI.

Conclusions:

• The incidence of UTIs caused by ESBL-producing bacteria is rising among Korean infants.
• Recognizing the distinct clinical course and risk factors for ESBL-producing UTIs is crucial for effective management.
• This study highlights the need for updated clinical guidelines to address the challenge of resistant bacterial UTIs in infants.