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Extended-Spectrum b-Lactamase-Producing Enterobacteriaceae Causing Community-Acquired Urinary Tract Infections in
Jhon Camacho-Cruz1, Javier Munoz Martinez2, Julio Mahecha Cufino2
1Department of Pediatrics, Fundación Universitaria de Ciencias de la Salud (FUCS) - Hospital de San José and Hospital Infantil Universitario de San José de Bogotá, Colombia. Correspondence to: DrJhon Camacho, Associate Instructor, Department of Pediatrics FUCS,Calle 10, No.18-75 Bogota, Colombia. jhcamacho@fucsalud.edu.co.
Insights
This study characterized pediatric urinary tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in Bogotá. ESBL-producing bacteria were found in 5% of community-acquired UTIs, with E. coli being the most common pathogen.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Antimicrobial resistance
Background:
- Community-acquired urinary tract infections (UTIs) are common in children.
- Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae pose a significant treatment challenge.
- Characterizing local resistance patterns is crucial for effective management.
Purpose of the Study:
- To describe pediatric patients with community-acquired UTIs caused by ESBL-producing Enterobacteriaceae.
- To identify the predominant bacterial species and their antimicrobial susceptibility patterns.
- To inform treatment guidelines for pediatric UTIs in Bogotá.
Main Methods:
- Retrospective review of microbiological data from two pediatric centers in Bogotá.
- Analysis of first urine cultures from January 2012 to December 2018.
- Data collected and analyzed using WHONET software.
Main Results:
- 132 pediatric patients with ESBL-producing Enterobacteriaceae UTIs were identified.
- ESBL-producing bacteria accounted for 5% of community-acquired UTIs.
- Escherichia coli was the most frequent pathogen (93.2%), followed by Klebsiella spp. (6.8%) and Proteus mirabilis (0.8%).
- Predominance of female sex, preschool children, and lower UTIs with few comorbidities.
Conclusions:
- Community-acquired UTIs caused by ESBL-producing Enterobacteriaceae in Bogotá pediatric patients are infrequent but significant.
- E. coli is the primary pathogen, necessitating targeted antimicrobial stewardship.
- Amikacin and nitrofurantoin showed adequate sensitivity, offering potential treatment options.
Objective:
To characterize the pediatric patients presenting at the two pediatric centers in Bogotá, with first isolate urine culture of community-acquired extended-spectrum b-lactamase (ESBL)-producing enterobacteriaceae.
Methods:
Review of microbiological data of children between January, 2012 and December, 2018, obtained using the WHONET software.
Results:
A total of 2657 Escherichia coli, Klebsiella spp and Proteus mirabilis - positive urine cultures were obtained within a 6-year period; data of 132 patients were finally selected. Frequency of ESBL-producing bacteria infections in community-acquired urinary tract infections (UTI) was 5%: 123 E. coli (93.2%), 7 K. pneumoniae (5.2%), 1 K. oxytoca (0.8%), and 1 P. mirabilis (0.8%).
Conclusion:
A predominance of female sex, preschool children, and lower tract urinary infections were found, as well as a low frequency of comorbidities. Adequate sensitivity to amikacin and nitrofurantoin was found in this study.
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