Open Access, Peer-reviewed
pISSN 2384-1079
eISSN 2384-1087
    Pediatr Infect Vaccine. 2015 Apr;22(1):29-35. Korean.
    Published online Apr 23, 2015.
    https://doi.org/10.14776/piv.2015.22.1.29
    Copyright © 2015 The Korean Society of Pediatric Infectious Diseases
    Original Article

    Febrile Urinary Tract Infections Caused by Community-Acquired Extended-Spectrum β-Lactamase-Producing and-Nonproducing Bacteria: A Comparative Study

    Do Hee Ahn, M.D., Kyu Won Kim, M.D., Hye-Kyung Cho, M.D., Han Tchah, M.D., In Sang Jeon, M.D., Eell Ryoo, M.D. and Yong Han Sun, M.D.
      • Department of Pediatrics, Graduate School of Medicine, Gachon University, Incheon, Korea.
    • Corresponding author (Email: hkcho@gilhospital.com )
    Received October 07, 2014; Revised October 28, 2014; Accepted October 29, 2014.

    Abstract

    Purpose

    The purpose of this study was to investigate the clinical characteristics and outcome of febrile urinary tract infections (UTIs) caused by community-acquired extended-spectrum β-lactamase (CA-ESBL)-producing and -nonproducing bacteria.

    Methods

    We analyzed febrile UTIs in children hospitalized at Gachon University Gil Medical Center from January 2011 to December 2013 through retrospective data collection from their medical records.

    Results

    Among pathogens causing 374 episodes of UTIs, the proportion of ESBL-producing bacteria was 13.1% (49/374). The proportion of ESBL-producing Escherichia coli and Klebsiella spp. was 13.6% (48/354) and 5.0% (1/20), respectively. There was no significant difference between the CA-ESBL and CA non-ESBL groups in duration of fever (4.2±2.7 vs.3.7±2.1 days, P=0.10) and bacterial eradication rate with empirical antibiotics (100% vs. 100%). The risk of cortical defects on renal scan significantly depended on existence of vesicoureteral reflux rather than ESBL production of pathogen.

    Conclusions

    There was no significant difference between the CA-ESBL and CA non-ESBL groups in renal cortical defects and clinical outcome. Careful choice of antibiotics is important for treatment of community-acquired UTI in children.

    Keywords
    Urinary tract infection; Extended-spectrum β-lactamase

    Tables

    Table 1
    Demographic and Clinical Characteristics of Febrile Urinary Tract Infections Caused by CA- ESBL-Producing and -Nonproducing Bacteria

    Table 2
    Antibiotic Resistance of CA-ESBL Producing and Nonproducing Bacteria in Febrile Urinary Tract infections

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    MeSH Terms
    Anti-Bacterial Agents
    Bacteria*
    Child
    Data Collection
    Escherichia coli
    Fever
    Humans
    Klebsiella
    Medical Records
    Retrospective Studies
    Urinary Tract Infections*
    Vesico-Ureteral Reflux
    beta-Lactamases
    Metrics
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    Tables
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