PEDIATRIC RISK FACTORS AND CHARACTERISTICS OF URINARY TRACT INFECTIONS CAUSED BY ESBL VERSUS NON ESBL ORGANISMS AT MAKASSED GENERAL HOSPITAL
Journal Title: European Journal of Biomedical and Pharmaceutical Sciences - Year 2018, Vol 5, Issue 8
Abstract
Background: Urinary tract infections (UTIs) are among the most common infectious diseases in pediatrics encountered in the community and in the hospital. Resistance to antibiotics in members of Gram-negative Enterobacteriaceae rose tremendously; highlighted by the emergence of extended spectrum beta-lactamase (ESBL) producing organisms. The incidence of community-onset UTIs caused by ESBL-producing E. coli in children is increasing and the previous use of antibiotics was considered a major risk factor. Objectives: To determine the risk factors of community-onset UTIs caused by ESBL-producing E. coli in children, study the difference in presentation and laboratory with radiologic findings with those who have non ESBL isolates UTI, and to assess the rate and antibiotics susceptibility of the ESBL isolates. Methods: A retrospective cross-sectional study was conducted at Makassed General Hospital in Beirut. Subjects were identified by the following ICD-10 discharge codes: “Urinary tract infection”, “Cystitis”, and “Pyelonephritis.” Children between 1 month and 18 years of age admitted for UTI between January 1st, 2012 and December 31st, 2017 were included. Cases whose urine culture result did not meet our definition for UTI or showed no growth and patients who had long stay at hospital were excluded. Results: During the study period, 292 charts have been reviewed, 14 patients were excluded, the remaining 278 were divided into 2 groups; ESBL (103 cases) and non ESBL (175 cases) isolated pathogens with a female predominance (85%). Vesico-ureteral reflux and previous antibiotics use with recent hospitalization and recurrent UTI were found to be independent risk factors for ESBL-producing E. coli and Klebsiella spp. (p < 0.05). Presenting fever was found most common in non ESBL group compared to ESBL (72.3% vs. 56.3% respectively; p-value=0.008), in contrast to dysuria which was more common in ESBL group (35.9% vs. 20.3%; p-value=0.005). Laboratory and radiologic findings showed no statistical significance, however advanced VUR was related to ESBL isolates. The proportions of ESBL-producing organisms causing UTI were increasing and they doubled over the study period (50%). A significant resistance to monobactam with cephalosporins and Bactrim was found >50%, however a complete sensitivity to carbapenems in ESBL pathogens is present. Conclusion: The recognition of risk factors for infection with ESBL-producing organisms and the observation of increasing resistance to antibiotics warrant further studies that might lead to new recommendations to guide management of UTIs and antibiotic use in children and adolescents.
Authors and Affiliations
Majdi Said
Keywords
Related Articles
- EP ID EP637215
- DOI -
- Views 145
- Downloads 0
MEAN VOLUMETRIC DIMENSIONS AND PNEUMATIZATION TYPES OF SPHENOID SINUS IN A NIGERIAN POPULATION (A CROSS-SECTIONAL RADIOLOGICAL STUDY).
Background: The sphenoid sinus is the most inaccessible among the paranasal sinuses. Nevertheless, it is of great surgical importance to both otorhinolaryngologists and neurosurgeons due to its role in chronic sinusitis...
THE DIFFERENCE OF EFFECTIVENESS OF LOCAL CLEANING AND ANTIFUNGAL APPLICATION IN THE TREATMENT OF OTOMYCOSIS BETWEEN AFRICAN AND NON AFRICAN PATIENTS IN LIBERIA
Objective: To determine the difference of effectiveness of the local toileting and the application of antifungal creams in the management of otomycosis between African and Non African patients in Liberia. Method: Cross –...
SPERM PARAMETERS AND TESTOSTERONE PROFILE OF SPRAGUE DAWLEY RATS WITH PALA KALYANA GHRITA: A TRADITIONAL FORMULA
Pala Kalyana Ghrita (PKG) is a poly herbal traditional medicine used for enhancement of fertility in both partners. However, the scientific evaluation of these natural resources are yet to be explored. So, to add to the...
CHEMICAL COMPOSITION OF THE ESSENTIAL OILS DISTILLED FROM TUBER OF RUMPUT TEKI (CYPERUS ROTUNDUS LINN.) GROWING IN TANGGAMUS, LAMPUNG, INDONESIA
In order to investigate chemical aspects of the Cyperaceae plant family in Lampung Province, Indonesia, this study is aimed to find out chemical composition of the distilled essential oils from rhizomes of rumput teki (C...
THE AVERAGE OF HBA AMONG SELECTED GROUP OF SUDANESE PATEINTS WITH FERTILITY DISORDERS
Background: Sperm hyaluronan binding may be an indicator of which sperm are most likely to produce a viable pregnancy. For example, mature, hyaluronan-binding sperm are essentially free of cytoplasmic inclusions. This is...