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Urinary tract infection caused by extended-spectrum β-lactamase-producing bacteria: Risk factors and antibiotic
Jumana H Albaramki1,2, Tariq Abdelghani1,2, Alaa Dalaeen1,2
1Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan.
Insights
Previous hospitalization and recurrent urinary tract infections (UTIs) are key risk factors for acquiring extended-spectrum β-lactamase (ESBL)-producing bacteria in children. Identifying these factors aids in managing ESBL-UTI cases effectively.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Resistance
- Urology
Background:
- Community-acquired urinary tract infections (UTIs) pose a significant health challenge.
- Extended-spectrum β-lactamase (ESBL)-producing bacteria are increasingly implicated in UTIs.
- Understanding risk factors for ESBL acquisition is crucial for effective treatment.
Purpose of the Study:
- To identify risk factors associated with acquiring ESBL-producing bacteria in pediatric community-acquired UTIs.
- To evaluate the antimicrobial resistance patterns of ESBL-producing bacteria in UTIs.
Main Methods:
- Retrospective evaluation of medical records of hospitalized children with community-acquired UTIs.
- Matching of children with ESBL-producing bacteria UTI (cases) with controls having non-ESBL-producing bacteria UTI.
- Logistic regression analysis to determine independent risk factors.
Main Results:
- 46% of community-acquired UTIs were caused by ESBL bacteria.
- Previous antibiotic use, hospitalization, recurrent UTI history, and renal anomalies were significant potential risk factors.
- History of previous hospitalization within 3 months was an independent risk factor (OR, 3.83).
- ESBL group showed higher resistance to amoxicillin-clavulanate, amikacin, gentamycin, and quinolones.
Conclusions:
- Identifying risk factors for ESBL-UTI is essential for early detection and management.
- Previous hospitalization emerges as a critical independent risk factor.
- Targeted interventions for high-risk children can mitigate ESBL-UTI acquisition.
Background:
The aim of this study was to investigate the risk factors for acquisition of extended spectrum β-lactamase (ESBL)-producing bacteria in community-acquired urinary tract infection (UTI) and to evaluate their antimicrobial resistance.
Methods:
The medical records of hospitalized children were retrospectively evaluated. Children with ESBL-producing bacteria UTI were matched with controls with non-ESBL-producing bacteria UTI of the same age and gender.
Results:
A total of 243 patients with community-acquired UTI in a 5 year period were evaluated, of whom 46% had UTI caused by ESBL bacteria. Seventy-seven cases were matched with 77 controls. There were no significant differences in the clinical presentation between the two groups apart from a longer hospital stay in the ESBL group (9.1 ± 5.5 days vs 8.0 ± 4.4 days, P = 0.013). Significant potential risk factors for ESBL-UTI were previous use of antibiotics in the last 3 months, previous hospitalization in the last 3 months, history of recurrent UTI, and presence of renal anomalies. On logistic regression analysis, history of previous hospitalization in the last 3 months (OR, 3.83; 95%CI: 1.49-9.84) was identified as an independent significant risk factor for ESBL-UTI. There was a significantly higher resistance to amoxicillin-clavulanate, amikacin, gentamycin and quinolones in the ESBL group compared with the control group.
Conclusion:
Recognizing the risk factors for ESBL-UTI helps to identify the high-risk cases and enables proper management.
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