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Urinary tract infection in infants caused by extended-spectrum beta-lactamase-producing Escherichia coli: comparison between urban and rural hospitals

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Abstract

Background

Community-acquired urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is an emerging problem. Compared with urban infants, rural infants may encounter different distributions of community-acquired resistant strains and various barriers to efficient management.

Methods

A retrospective survey and comparison was conducted for infants with UTI caused by ESBL-producing E. coli admitted to an urban hospital (n = 111) and a rural hospital (n = 48) in southern Taiwan from 2009 to 2012.

Results

Compared with 2009 and 2010, the total number of cases at both hospitals significantly increased in 2011 and 2012 (p < 0.001). Compared with the rural patients, the urban patients were significantly younger, and they had fewer days of fever before and after admission, fewer presentations of poor activity and poor appetite, and a lower serum creatinine level. Most of the patients had no prior history of illness, and we could not identify any significant different risk factors for acquiring ESBL-producing E. coli, such as past antimicrobial use, hospitalization, UTI, and underlying renal diseases, between the urban and rural populations.

Conclusions

The increase in community-acquired UTI in infants caused by ESBL-producing E. coli was similar between the urban and rural populations. Our preliminary data suggest that the rural–urban disparities were probably related to easy access to health care by the urban population. ESBL complicates disease management, and the increase in the prevalence of ESBL producers is a major health concern and requires further healthy carrier and environmental surveillance.

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Acknowledgments

This study was supported by a grant (VGHKS104-082) from Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

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Authors and Affiliations

  1. Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Ming-Fang Cheng, Wan-Ling Chen, I-Fei Huang & Yee-Hsuan Chiou

  2. School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Ming-Fang Cheng, Wan-Ling Chen, I-Fei Huang, Yee-Hsuan Chiou, Yao-Shen Chen & Susan Shin-Jung Lee

  3. Fooyin University, Kaohsiung, Taiwan

    Ming-Fang Cheng & Yee-Hsuan Chiou

  4. Department of Pediatrics, Pingtung Branch of Veterans General Hospital–Kaohsiung, Pingtung, Taiwan

    Wan-Ling Chen

  5. Department of Biological Science and Technology, College of Medicine, I-Shou University, Kaohsiung, Taiwan

    Jung-Ren Chen

  6. Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Yao-Shen Chen & Susan Shin-Jung Lee

  7. Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering, I-Shou University, No. 1, Sec. 1, Syuecheng Rd., Dashu District, Kaohsiung City, 84001, Taiwan (R.O.C)

    Wan-Yu Hung & Chih-Hsin Hung

  8. Department of Internal Medicine, National Cheng Kung University Hospital, No.1, University Road, Tainan City, 701, Taiwan (R.O.C)

    Jiun-Ling Wang

Authors
  1. Ming-Fang Cheng
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  2. Wan-Ling Chen
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  3. I-Fei Huang
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  4. Jung-Ren Chen
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  7. Susan Shin-Jung Lee
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  8. Wan-Yu Hung
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  9. Chih-Hsin Hung
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Corresponding authors

Correspondence to Chih-Hsin Hung or Jiun-Ling Wang.

Ethics declarations

This study was approved by the Institutional Review Board (VGHKS13-CT1-01) of both hospitals.

Conflict of interest

The authors have no conflicts of interest to disclose

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Cheng, MF., Chen, WL., Huang, IF. et al. Urinary tract infection in infants caused by extended-spectrum beta-lactamase-producing Escherichia coli: comparison between urban and rural hospitals. Pediatr Nephrol 31, 1305–1312 (2016). https://doi.org/10.1007/s00467-016-3338-0

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  • DOI: https://doi.org/10.1007/s00467-016-3338-0

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