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Increasing Prevalence of Pediatric Community-acquired UTI by Extended Spectrum β-Lactamase-producing E. coli: Cause
Joshua D Collingwood1, April H Yarbrough2, Suresh B Boppana3
1Department of Research, Alabama College of Osteopathic Medicine, Dothan, Alabama.
Insights
Community-acquired urinary tract infections (UTIs) caused by emerging spectrum-β-lactamase (ESBL) producing E. coli are increasing in children. This trend highlights the urgent need to understand antibiotic resistance profiles in pediatric populations.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance
- Bacteriology
Background:
- Emerging spectrum-β-lactamase (ESBL) infections, particularly E. coli UTIs, represent a growing public health concern.
- Limited data exists on the antibiotic resistance profiles of community-acquired (CA) ESBL-E. coli UTIs in pediatric patients.
- This study addresses the rising trend and resistance patterns of pediatric ESBL-E. coli UTIs.
Approach:
- A retrospective study analyzed data from a pediatric hospital's infectious disease database (01/2015–01/2021).
- Demographic information and antimicrobial susceptibility test results for ESBL-E. coli isolates from CA-UTIs were collected.
- Annual changes in resistance and presentation rates of ESBL-E. coli UTIs were reported.
Key Points:
- From 2015 to 2021, ESBL-E. coli was identified in 169 urine cultures from 135 children.
- Community-acquired UTIs caused by ESBL-producing E. coli increased from 0.97% in 2015 to 3.54% in 2020.
- Most ESBL-E. coli isolates exhibited multidrug resistance.
Conclusions:
- There is a demonstrable increase in community-acquired ESBL-E. coli UTIs among children.
- The rising prevalence of multidrug-resistant ESBL-E. coli UTIs in pediatric patients is concerning.
- These infections are linked to prolonged hospital stays and increased morbidity, underscoring the need for vigilance.
Background:
Antimicrobial resistance and emerging spectrum-β-lactamase (ESBL) infections are a rising concern in public health. Despite the increasing prevalence of community-acquired (CA) ESBL-E. coli UTIs, there is little data on the antibiotic resistance profiles of this bacterial strain in the pediatric population. We review antibiotic resistance profile and rising trend in pediatric ESBL-E. coli UTI presentation at our pediatric hospital.
Methods:
This retrospective study reviewed data drawn from the infectious disease database at our pediatric hospital for all patients whose urine culture grew ESBL-E. coli from 01/2015 to 01/2021. Demographic information and antimicrobial susceptibility test results for ESBL-E. coli isolates from CA-UTIs were collected. Annual changes in resistance to antimicrobial agents and average annual percent change in ESBL-E. coli UTI presentation over the study period are reported.
Results:
From 01/2015 to 01/2021, 6403 urine cultures at our hospital grew E. coli. Of these, 169 urine cultures from 135 children grew ESBL-E. coli. The study population was 57% male (77) with a mean age of 6.9 ± 6.2 years and multiethnic. CA-UTI by ESBL-producing E. coli accounted for 2.62% of total E. coli UTIs within the study period and increased from 0.97% in 2015 to 3.54% in 2020 by an average of 0.51% each year.
Conclusions:
These findings demonstrate an increase in CA-ESBL E. coli UTIs in children. We observed most isolates demonstrated multidrug resistance. As CA-ESBL E. coli UTIs are associated with prolonged hospitalization and increased morbidity, our findings highlight the rising trend in pediatric CA-ESBL E. coli UTI.
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