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Urinary tract infections in children < 2 years of age hospitalized in a tertiary medical center in Southern Israel: epidemiologic, imaging, and microbiologic characteristics of first episode in life

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Abstract

The objectives of the study were to describe the epidemiologic, microbiologic, and imaging characteristics of first 44 UTI episode in hospitalized infants and children < 2 years of age. A UTI episode was diagnosed based on suprapubic aspiration or urinary catheterization and report of a significant bacterial growth of true uropathogens. Two thousand two hundred ninety-four UTI episodes were recorded during 2009–2013 in 1694 patients; 1350 (79.7%), 223 (13.2%), and 66 (3.9%) had one, two, and three episodes, respectively. Of 1955 pathogens isolated, the most frequent were E. coli, Klebsiella spp., and Enterococcus spp. (56.9%, 14.1%, and 11%, respectively). E. coli percentages increased with increase in patient age while Klebsiella spp. and Enterococcus spp. decreased with decrease in age. 136/344 (39.5%) renal ultrasound examinations performed were reported abnormal. The percentages of abnormal ultrasound examinations in Enterococcus spp.-UTI were higher than in E. coli and Klebsiella spp.-UTI (P < 0.001 and P = 0.007, respectively). The E. coli nonsusceptibility to ampicillin, TMP/SMX, ceftriaxone, amoxicillin/clavulanic acid, cefuroxime, and gentamicin was 71%, 31%, 14.9%, 14.7%, 7%, and 4.4%, respectively. Nonsusceptibility of Klebsiella spp. to ampicillin, amoxicillin/clavulanic acid, TMP/SMX, ceftriaxone, gentamicin, and cefuroxime was 98.7%, 10.4%, 9.5%, 8.4%, 4.8%, and 4.3%, respectively. E. coli nonsusceptibility to amoxicillin/clavulanate, TMP/SMX, and ciprofloxacin decreased during the study period. E. coli percentages increased and those of Klebsiella spp. and Enterococcus spp. decreased with increase in patient age. Enterococcus. spp.-UTI was associated with older age and more severe findings on renal ultrasound. E. coli and Klebsiella spp. nonsusceptibility to amoxicillin/clavulanate, TMP/SMX, cefuroxime, and ceftriaxone was low.

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Authors and Affiliations

  1. Division of Pediatrics, Soroka University Medical Center, Ben-Gurion University, P.O. Box 151, 84101, Beer Sheva, Israel

    David Shaki, Siham Elamour, Raouf Nassar, Eyal Kristal, Ron Leibovitz, Amir Horev & Eugene Leibovitz

  2. Pediatric Infectious Disease Unit, Soroka University Medical Center, Ben-Gurion University, Beer Sheva, Israel

    David Shaki, Siham Elamour & Eugene Leibovitz

  3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Gabriel Hodik

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  1. David Shaki
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  2. Gabriel Hodik
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  3. Siham Elamour
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  6. Ron Leibovitz
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  8. Eugene Leibovitz
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Correspondence to Eugene Leibovitz.

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The research protocol was approved by the Ethics Committee of the Soroka University Medical Center.

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Shaki, D., Hodik, G., Elamour, S. et al. Urinary tract infections in children < 2 years of age hospitalized in a tertiary medical center in Southern Israel: epidemiologic, imaging, and microbiologic characteristics of first episode in life. Eur J Clin Microbiol Infect Dis 39, 955–963 (2020). https://doi.org/10.1007/s10096-019-03810-w

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  • DOI: https://doi.org/10.1007/s10096-019-03810-w

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