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Extended-spectrum Beta-lactamase-producing Community-acquired Urinary Tract Infections in Children: Chart Review of
Sundaram Balasubramanian1, Dhanalakshmi Kuppuswamy1, Swathi Padmanabhan1
1Department of Pediatrics, Kanchi Kamakoti CHILDS Trust Hospital and CHILDS Trust Medical Research Foundation, Chennai, Tamil Nadu, India.
Insights
Community-acquired urinary tract infections (CA-UTI) caused by extended-spectrum beta-lactamase (ESBL) producing organisms are increasing globally. This study found no significant risk factors predicting ESBL-UTI in children, though resistance to common antibiotics was noted.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance
- Clinical microbiology
Background:
- Rising global incidence of community-acquired urinary tract infections (CA-UTI) caused by extended-spectrum beta-lactamase (ESBL) producing organisms.
- Identified risk factors for ESBL-producing organisms include young age, uroprophylaxis, recurrent UTIs, and recent antibiotic use.
Purpose of the Study:
- To correlate known risk factors with the occurrence of ESBL-UTI in pediatric patients.
- To analyze the antibiotic susceptibility patterns of isolated uropathogens.
Main Methods:
- Clinical and microbiological data were collected from 100 children aged 1 month to 12 years with CA-UTI.
- Risk factors were compared between ESBL-producing and non-ESBL producing groups.
- Statistical analysis was performed to identify significant predictors.
Main Results:
- Antimicrobial sensitivity testing revealed high resistance to commonly used UTI treatments like cephalosporins, cotrimoxazole, fluoroquinolones, and amoxicillin-clavulanic acid.
- Most isolates remained sensitive to aminoglycosides, piperacillin-tazobactam, and carbapenems.
- Statistical analysis did not identify any significant risk factors that predispose to ESBL-UTI.
Conclusions:
- Despite the increasing prevalence of ESBL-producing organisms in pediatric CA-UTI, no specific risk factors were identified in this study.
- The observed antimicrobial resistance patterns highlight the need for judicious antibiotic selection, favoring agents like aminoglycosides, piperacillin-tazobactam, and carbapenems.
Background:
Community acquired urinary tract infections (CA-UTI) caused by extended spectrum beta lactamase (ESBL) producing organisms is on the rise throughout the world. There are known risk factors such as age <1 year, children on uroprophylaxis, recurrent UTI, recent antibiotic usage etc which can predict the occurrence of these ESBL producers.
Objectives:
To correlate known risk factors with occurrence of ESBL UTI and antibiotic susceptibility of uropathogens isolated.
Materials And Methods:
Clinical and microbiological data were collected from 100 children 1month to 12 years with CA-UTI. The risk factors were compared in the ESBL and non-ESBL group and analysed.
Results And Conclusion:
The antimicrobial sensitivity pattern in our study showed increased resistance to cephalosporins, cotrimoxazole, fluoroquinolones and amoxicillin-clavulanic acid which are frequently used in the treatment of UTI, with most isolates being sensitive to aminoglycosides, piperacillin-tazobactam and carbapenems. Statistical analysis did not identify any significant risk factor that predisposes to ESBL UTI.
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