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High Rates of ESBL-producing and Gentamycin-resistant Gram-negative Bacteria During the First Week of Life: A

Muhammad Washahi1, Dan Miron2, Zohar Steinberg Ben Zeev2

  • 1From the Pediatric Department.

The Pediatric Infectious Disease Journal
|May 31, 2023
PubMed

Insights

In infants under two months with urinary tract infections (UTIs), Extended Spectrum Beta-Lactamase (ESBL) and gentamicin resistance are significant concerns. Higher resistance rates in the first week of life suggest a need for treatment protocol review.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Urinary tract infections (UTIs) in infants require prompt antimicrobial treatment to prevent renal scarring.
  • Current recommendations for febrile infants under 2 months involve empirical gentamicin and ampicillin.
  • The rise of antimicrobial resistance necessitates evaluating the effectiveness of these treatments.

Purpose of the Study:

  • To determine the prevalence of Extended Spectrum Beta-Lactamase (ESBL)-producing and gentamicin-resistant Gram-negative UTIs in infants younger than 2 months.
  • To identify factors associated with these resistant bacterial infections in this age group.

Main Methods:

  • A multicenter retrospective cross-sectional study was conducted.
  • Data were collected from pediatric emergency departments between January 2016 and December 2021.
  • The study included 1142 infants under 2 months with UTIs.

Main Results:

  • The prevalence of gentamicin-resistant UTI was 5.7%, and ESBL-producing UTI was 5.6%.
  • Infants in the first week of life exhibited higher rates of both ESBL (14.8%) and gentamicin resistance (11.2%).
  • Higher admission rates to pediatric intensive care units (ICUs) were observed in infants with ESBL-associated UTIs (9.8%).

Conclusions:

  • Current empirical treatment guidelines are generally supported.
  • Treatment protocols may require modification for infants younger than 7 days due to elevated resistance rates.
  • Further investigation into resistance patterns in neonates is warranted.
Abstract

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