The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 6
Urinary tract infections caused by extended-spectrum betalactamase-producing bacteria in children: a matched casecontrol study
1st Department of Pediatrics, Aristotle University, Hippokratio Hospital, Thessaloniki, Greece. E-mail: yandot@med.auth.gr
Extended-spectrum beta-lactamase (ESBL)-producing pathogens are emerging
as a cause of urinary tract infections (UTI) worldwide. In this matched-case
control study, clinical characteristics and associated risk factors for ESBL
UTI were evaluated. In a total of 463 positive urine cultures, 48 (10.4%)
(from 39 patients, 23 boys) were phenotypically ESBL-producing bacteria.
The most frequently isolated microorganism was , followed
by Klebsiella spp. and Enterobacter cloacae. Children with ESBL UTI (n=39)
were on prophylaxis more (21% vs. 6%, p=0.01), had higher rates of urinary
tract anomalies (36% vs. 10%, p=0.0007), presented abnormal 99m Tcdimercaptosuccinic
acid (DMSA) findings (i.e. scars) (23% vs. 4%, p=0.001),
and had longer hospitalization (9.8 vs. 7.4 days, p=0.004) compared to those
with non-ESBL UTI (n=117). The recognition of risk factors for UTI caused
by ESBL bacteria in children may aid in the identification of high-risk cases
and may enable proper management of these patients.
Keywords :
extended-spectrum beta-lactamase (ESBL), urinary tract infection, clinical
characteristics, risk factors.