Incidence and Risk factors to Extended-Spectrum β-Lactamase-Producing Bacteria in Urinary Tract Infection in Children
2Pediatric department, Hillel Yaffe Medical Center
3Infectious disease and infection control unit, Hillel Yaffe Medical Center
Background: Extended spectrum beta lactamase (ESBL) -producing bacteria incidence in urinary tract infection (UTI) in children is rising. Identify pathogens is important for proper empiric antibiotic treatment. In this study we aim to assess the update frequency and risk factors for UTI caused by ESBL-producing bacteria.
Methods: This is case-control retrospective research. Data was collected from medical records of children who had positive urine sample with ESBL-producing bacteria in 2015-2020. Controls are patients who had positive urine sample caused by non-ESBL producing bacteria at same period.
Results: 76 Cases with ESBL positive urine sample were compared with 76 cases with non ESBL positive urine sample. First, we discovered that the incidence in our area increased from 2.4% in 2015 to around 9% in 2019. In 2020, the incidence decreased dramatically to 4.3%. We discovered that the patient in the research group were more likely to be from Arab decent rather than Jewish (OR 2.6 p. value=0.021) recent us of antibiotics (OR 3.1, p-value=0.004) and specifically UTI prophylaxis antibiotics (OR 6.9, p-value=0.009).
Discussion: The incidence of ESBL positive UTI is rising. In 2020, we saw a decline in contrast to the previous years trend. We assume that due to the COVID-19 pandemic there were less healthcare admission and less antibiotic use. We found that the risk factors for ESBL-positive UTI are Arab descent, Previous antibiotic use and usage of prophylaxis antibiotics. Those are important factor that should be taken in consider when choosing proper treatment for UTI.