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Pediatric Nephrology

, Volume 29, Issue 9, pp 1583–1587 | Cite as

Extended-spectrum β-lactamase-producing bacteria causing community-acquired urinary tract infections in children

  • Orli Megged
Original Article

Abstract

Background

Extended-spectrum β-lactamase (ESBL)-producing bacteria are infrequent pathogens of community-acquired (CA) urinary tract infections (UTIs) in children. The aim of this study was to assess the frequency of and identify risk factors for CA-UTIs due to ESBL-producing microorganisms (CA-ESBL-UTI).

Methods

The medical records of all children diagnosed with CA-ESBL-UTI at our medical center between 2003 and 2013 were reviewed. Patients with non-ESBL-UTIs during the same period were included as controls.

Results

Eighty cases of CA-ESBL-UTI were identified. The incidence of ESBL-UTI increased from 2 to 3.8% during the study period. Compared to children with non-ESBL-UTI, those with ESBL were more likely to be of Arab descent, to have underlying medical conditions, to have received antibiotics in the month prior to the UTI and to have been previously hospitalized. The mean duration of hospitalization for patients with an ESBL-UTI was significantly longer than that for patients with a non-ESBL UTI (3.6 vs. 2 days; P = 0.01). In multivariate analysis, Arab ethnicity [odds ratio (OR) 6.1; 95 % confidence interval (CI) 2.7–13.6] and recent antibiotic treatment (OR 4.0; 95 % CI 1.6–10.4) were risk factors for CA-ESBL-UTI.

Conclusions

The incidence of CA-ESBL-UTI is rising. The empiric treatment for suspected UTI in children who had been previously hospitalized and who had received antibiotics in the last month should cover ESBL-producing bacteria.

Keywords

Extended-spectrum β-lactamase Urinary tract infection Children Community-acquired infection 

Notes

Conflict of interest

None.

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Copyright information

© IPNA 2014

Authors and Affiliations

  1. 1.Pediatric Department and Infectious Diseases UnitShaare Zedek Medical Center affiliated with Hebrew University-Hadassah School of MedicineJerusalemIsrael

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