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Uropathogenic Escherichia coli ST131 in urinary tract infections in children

Ki Wook Yun1, Mi-Kyung Lee2, Wonyong Kim3

  • 1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.

Korean Journal of Pediatrics
|September 2, 2017
PubMed

Insights

Multidrug-resistant Escherichia coli sequence type 131 (ST131) is a common cause of urinary tract infections in Korean children. While ST131 strains show increased antimicrobial resistance, they do not lead to different clinical outcomes compared to other strains.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Escherichia coli sequence type 131 (ST131) is a globally prevalent multidrug-resistant clone responsible for extraintestinal infections.
  • The epidemiology and clinical characteristics of ST131 infections in pediatric populations remain incompletely understood.

Purpose of the Study:

  • To investigate the characteristics of ST131 Escherichia coli isolates from pediatric urinary tract infections in Korea.
  • To compare the clinical features and antimicrobial susceptibility of ST131 and non-ST131 uropathogenic E. coli (UPEC) in children.

Main Methods:

  • Analysis of 114 uropathogenic E. coli (UPEC) isolates from children hospitalized between 2011 and 2014.
  • Sequence typing of seven housekeeping genes to classify bacterial strains into sequence types (STs).
  • Comparison of clinical data and antimicrobial susceptibility profiles between ST131 and non-ST131 UPEC isolates.

Main Results:

  • ST131 was identified in 13.2% of pediatric UPEC isolates, with a higher prevalence among extended-spectrum β-lactamase (ESBL)-producing strains (50.0%).
  • ST131 isolates exhibited significantly lower susceptibility to cefazolin, cefotaxime, cefepime, and ciprofloxacin compared to non-ST131 isolates (P<0.001 for all).
  • No significant differences were observed in clinical characteristics or outcomes between patients infected with ST131 and non-ST131 UPEC.

Conclusions:

  • ST131 Escherichia coli is a prevalent uropathogen in Korean children, associated with increased antimicrobial resistance.
  • Despite higher resistance rates, ST131 infections in children do not appear to result in distinct clinical presentations or outcomes.
Abstract

Keywords:
ChildEscherichia coliMultilocus sequence typingUrinary tract infection

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