Urinary Tract Infections Caused By Extended-Spectrum Beta-Lactamase-Producing Escherichia Coli, Prevalence And Risk Factors In Hospitalized PEDIATRIC PATIENTS

Objective:

• E.coli is the predominant etiology for UTI.

• ESBL producing organisms increasing in prevalence.

• Suspicion for positive ESBL E.coli based on epidemiology, clinical or laboratory findings help to start proper empirical-treatment.

methods

• We retrospectively studied 815 pediatric patients with UTI who were hospitalized between 2012-2017.

• Patients divided into E.coli ESBL positive and other pathogens, clinical characteristics and outcomes were compared between those groups including:

Age.

Gender.

Admission days.

Ethnicity.

Admission temperature.

Culture collecting means.

Laboratory findings.

History of renal injury.

Previous UTI.

Antibiotics use in last 10 days before admission.

• Inclusion criteria:

0-15 years old.

Positive urine culture collected mid-stream, catheter or SPA.

• Exclusion Criteria:

Older than 15 years old.

Urine culture collected by other manners.

No blood analyzes.

Results

• 564/815 patients were included.

• 87.1% with UTI are girls.

• E.COLI obtained in 82%, whom ESBL positive in 8.7%.

• Incidence of positive ESBL E.coli increase in patients with:

• Previous UTI (12%)

• First month (7.4%) compared to the first two years of age (~3.3%)

• children >2 years old.

• Arabic community (10.1%)

• Renal disease (5.4%)

• Recently use of Antibiotics in last 10 days (20%)

• Similar incidence of positive ESBL were obtained regarding the gender (M8.2%/F8.8%)

• No difference in laboratory finding were obtained regarding UTI caused by ESBL E.coli and other pathogens.

• Conclusions

• Similar to recent studies, our study show an increase incidence of ESBL E.coli UTI in pediatric patients.

• Based on our data, the incidence is higher in Arab patients with previous history of UTI and who used recently antibiotics.