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European Journal of Pediatrics

, Volume 174, Issue 6, pp 783–790 | Cite as

Pathogens causing urinary tract infections in infants: a European overview by the ESCAPE study group

  • Irene Alberici
  • Aysun Karabay Bayazit
  • Dorota Drozdz
  • Sevinç Emre
  • Michel Fischbach
  • Jérôme Harambat
  • Augustina Jankauskiene
  • Mieczyslaw Litwin
  • Sevgi Mir
  • William Morello
  • Amira Peco-Antic
  • Peter Sallay
  • Lale Sever
  • Giacomo D. Simonetti
  • Przemyslaw Szczesniak
  • Ana Teixeira
  • Enrico Vidal
  • Elke Wuehl
  • Otto Mehls
  • Lutz T. Weber
  • Franz Schaefer
  • Giovanni MontiniEmail author
  • for the ESCAPE study group and the PREDICT trial
Original Article

Abstract

Knowledge of the distribution spectrum of causative organisms and their resistance patterns has become a core requirement for the rational and effective management of urinary tract infections. In the context of a prospective trial on the use of antibiotic prophylaxis in infants with underling kidney malformations, we conducted an online survey among paediatric nephrologists on positive urine cultures (July 2010–June 2012) from both hospitalized and non-hospitalized infants under 24 months of age. We collected 4745 urine cultures (UCs) at 18 units in 10 European countries. Escherichia coli was the most frequent bacterium isolated from UCs; however, in 10/16 hospitals and in 6/15 community settings, E. coli was isolated in less than 50 % of the total positive UCs. Other bacterial strains were Klebsiella, Enterococcus, Proteus and Pseudomonas not only from hospital settings. E. coli showed a high resistance to amoxicillin and trimethoprim and variable to cephalosporin. Nitrofurantoin had a good rate of efficacy, with 11/16 hospitals and 11/14 community settings reporting a resistance lower than 5 %.

Conclusion: E. coli is the most common organism causing UTIs in infants; however, other bacterial strains are frequently isolated. As a result, antibiotic prophylaxis should be more elastic and adaptable over time in order to guarantee maximum efficacy.

Keywords

Urinary tract infection Antibiotic resistance Infants Escherichia coli Urine culture 

Abbreviations

CLSI

Clinical and Laboratory Standards Institute

EUCAST

European Committee for Antimicrobial Susceptibility Testing

UCs

Urine cultures

UTI

Urinary tract infection

VUR

Vesico-ureteral reflux

Notes

Acknowledgments

Thanks to all the microbiology departments for the support given to the authors in the selection of the data: Simone Ambretti (Bologna), Akgun Yaman (Adana), Joanna Klepacka (Krakow), Derya Aydin (Istanbul), Jaulhac Benoit (Strasbourg), Emilie Bessede (Bordeaux), Genovaite Bernatoniene (Vilnius), Suzana Laban-Nestorović (Belgrade), Eva Kenesei (Budapest), Nigar Çelik Özer (Istanbul), SC Droz (Bern), Anna Komarnicka (Gdansk), Lucia Rossi (Padova), Irene Burckhardt (Heidelberg) and Johannes Huebner (Munich).

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Irene Alberici
    • 1
  • Aysun Karabay Bayazit
    • 2
  • Dorota Drozdz
    • 3
  • Sevinç Emre
    • 4
  • Michel Fischbach
    • 5
  • Jérôme Harambat
    • 6
  • Augustina Jankauskiene
    • 7
  • Mieczyslaw Litwin
    • 8
  • Sevgi Mir
    • 9
  • William Morello
    • 1
  • Amira Peco-Antic
    • 10
  • Peter Sallay
    • 11
  • Lale Sever
    • 12
  • Giacomo D. Simonetti
    • 13
  • Przemyslaw Szczesniak
    • 14
  • Ana Teixeira
    • 15
  • Enrico Vidal
    • 16
  • Elke Wuehl
    • 17
  • Otto Mehls
    • 17
  • Lutz T. Weber
    • 18
  • Franz Schaefer
    • 17
  • Giovanni Montini
    • 1
    Email author
  • for the ESCAPE study group and the PREDICT trial
  1. 1.Nephrology and Dialysis Unit, Department of PediatricsAzienda Ospedaliera Universitaria Sant’Orsola-Malpighi BolognaBolognaItaly
  2. 2.Division of Pediatric Nephrology, School of MedicineCukurova UniversityAdanaTurkey
  3. 3.Dialysis UnitJagielloniam UniversityKrakowPoland
  4. 4.Pediatric Nephrology Department, Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey
  5. 5.Service de PédiatrieCentre Hospitalier Universitaire HautepierreStrasbourgFrance
  6. 6.Service de Pédiatrie, Centre de Reference Maladies Rénales Rares du Sud OuestCentre Hospitalier Universitaire de BordeauxBordeauxFrance
  7. 7.Vilnius University Children HospitalVilniusLithuania
  8. 8.Department of NephrologyThe Children’s Memorial Health InstituteWarsawPoland
  9. 9.Faculty of MedicineEge UniversityIzmirTurkey
  10. 10.Division of Pediatric NephrologyUniversity Children’s HospitalBelgradeSerbia
  11. 11.Department of PediatricsSemmelweis UniversityBudapestHungary
  12. 12.Cerrahpasa School of MedicineIstanbul UniversityIstanbulTurkey
  13. 13.Pediatric NephrologyUniversity Children’s HospitalBernSwitzerland
  14. 14.Department Paediatrics, Nephrology and HypertensionMedical University GdanskGdanskPoland
  15. 15.Pediatric NephrologyUniversity Children’s HospitalPortoPortugal
  16. 16.Pediatric Nephrology, Dialysis and Transplantation Unit, Department of PediatricsUniversity of PadovaPadovaItaly
  17. 17.Division of Pediatric Nephrology, Center for Pediatrics and Adolescent MedicineUniversity of HeidelbergHeidelbergGermany
  18. 18.Pediatric Nephrology, Children’s and Adolescent’s HospitalUniversity Hospital of CologneCologneGermany

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