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Establishment and Characterization of UTI and CAUTI in a Mouse Model
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Pathogens Causing Pediatric Community Acquired Urinary Tract Infections and Their Increasing Antimicrobial

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Pathogens (Basel, Switzerland)
|March 27, 2024
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Pediatric urinary tract infections (UTIs) are often caused by Escherichia coli. Antimicrobial resistance is increasing, especially for extended-spectrum beta-lactamase-producing E. coli, necessitating updated treatment guidelines.

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Estherichia coliantibiotic resistanceantibiotic treatmentchildrenguidelinesurinary tract infectionsuropathogens

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Area of Science:

  • Pediatric infectious diseases
  • Antimicrobial resistance
  • Urology

Background:

  • Urinary tract infections (UTIs) are common in children, causing significant morbidity and potential long-term complications.
  • Optimizing empiric antibiotic therapy for pediatric UTIs requires up-to-date data on causative pathogens and their resistance patterns.

Purpose of the Study:

  • To investigate pathogens causing community-acquired UTIs in children.
  • To analyze correlations between uropathogens and demographic characteristics.
  • To identify trends in antimicrobial resistance of pediatric UTI pathogens over time.

Main Methods:

  • Nationwide cross-sectional study involving 53,203 children (<18 years) diagnosed with UTI.
  • Data collected from community outpatient clinics in selected years: 2007, 2011, 2015, 2019, and 2021.
  • Analysis of pathogen distribution, demographic correlations, and antimicrobial resistance trends.

Main Results:

  • Escherichia coli (E. coli) was the most frequent uropathogen (82.1%), followed by Enterobacter, Klebsiella, Proteus, Pseudomonas, and Enterococcus species.
  • Significant gender- and sector-specific patterns were observed, with higher non-E. coli UTI prevalence in Jewish males.
  • The rate of extended-spectrum beta-lactamase (ESBL)-positive E. coli significantly increased from 6.1% in 2007 to 25.4% in 2021.

Conclusions:

  • E. coli is the predominant pathogen in pediatric community-acquired UTIs, but resistance patterns are evolving.
  • Increasing ESBL-producing E. coli and resistance in non-E. coli uropathogens necessitate careful selection of empiric antibiotics.
  • Periodic, local assessment of antimicrobial resistance is crucial for updating treatment guidelines and ensuring effective therapy for pediatric UTIs.