Community-Acquired Pseudomonas aeruginosa Urinary Tract Infections in Children Hospitalized in a Tertiary Center: Relative Frequency, Risk Factors, Antimicrobial Resistance and Treatment

Marcus, Nir; Ashkenazi, Shai; Samra, Zmira; Cohen, Avner H.; Livni, Gilat

doi:10.1007/s15010-008-7328-4

Cited by 33 publications

(30 citation statements)

References 22 publications

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“…Different drugs have different drug resistance rates. Gad et al [22] and Marcus et al [23] reported a higher drug resistance rate with levofloxacin than the studies reported by Bitsori et al [15], Narten et al [24] and Shigemura et al [25], but a lower rate with amikacin than the studies reported by Narten et al [24] and Shigemura et al [25]. This result may be due to the differing antibacterial use guidelines in different hospitals.…”

Section: Discussionmentioning

confidence: 97%

Antimicrobial Susceptibilities and Clinical Characterization of Pseudomonas aeruginosa Isolates from Urinary Tract Infections

Zhang

Niu²,

Zhang³

2014

Urol Int

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Introduction:Pseudomonas aeruginosa is a uropathogen that is mainly involved in nosocomial infection. The aim of this study was to analyze the antimicrobial susceptibilities and clinical characterization of P. aeruginosa isolates from urinary tract infections (UTIs). Materials and Methods: The study collected all P. aeruginosa UTI strains from a hospital in Chongqing, China, from January 1st, 2010 to December 31st, 2011. The antibiotic susceptibilities of the P. aeruginosa isolates were analyzed using the agar dilution method and the genotypes were assessed using random amplification of polymorphic DNA-PCR (RAPD-PCR). The clinical characteristics of the patients with UTIs were collected from the hospital information systems, and significance was analyzed using the proportion test. Results: A total of 2,778 episodes of culture-proven UTIs were used in the study. There were 198 infections (7.1%) caused by P. aeruginosa. P. aeruginosa strains were highly resistant to most drugs tested. The RAPD-PCR data revealed that the 198 P. aeruginosa infections had 82 different genotypes. Antibacterial use, previous UTI, urinary tract catheter and urinary tract operation were found to be risk factors for the development of UTIs. Conclusions:P. aeruginosa is the second most common UTI pathogen in our hospital. We should closely monitor patients with risk factors for P. aeruginosa infection.

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Section: Discussionmentioning

confidence: 97%

Antimicrobial Susceptibilities and Clinical Characterization of Pseudomonas aeruginosa Isolates from Urinary Tract Infections

Zhang

Niu²,

Zhang³

2014

Urol Int

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“…Changes in the characteristics and causative pathogens of UTIs in hospital-treated children are continuously being reported [2,4,[6][7][8]. Concomitantly, changes in the antibiotic susceptibility patterns of pediatric uropathogens [2,3,[9][10][11] affect the empiric treatment of resultant infections.…”

Section: Introductionmentioning

confidence: 99%

Community-acquired enterococcal urinary tract infections in hospitalized children

et al. 2011

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The objectives of this study were to characterize community-acquired (CA) enterococcal urinary tract infections (UTIs) in a tertiary pediatric center and to determine risk factors for their occurrence, their association with renal abnormalities, their antibiotic susceptibility profile, and the appropriateness of the empiric antibiotic treatment, in comparison to those of Gram-negative UTIs. In a 5-year prospective clinical and laboratory study, we found that enterococcal UTIs caused 6.2% (22/355) of culture-proven CA UTIs. Compared with Gram-negative UTI, enterococcal UTI was associated with male predominance, higher rates of underlying urinary abnormalities (70 vs. 43.7%; p = 0.03) and inappropriate empiric antibiotic therapy (22 vs. 5.6%; p = 0.02), and mainly vesicoureteral reflux (53% of cases). This study highlights the importance of early detection of CA enterococcal UTIs because of their association with underlying urinary abnormalities and a high rate of inappropriate empiric antibiotic therapy. Renal imaging is recommended for children with enterococcal UTIs; Gram stain is suggested in selected cases to detect Gram-positive cocci for early diagnosis of enterococcal UTIs and initiation of appropriate antibiotics.

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“…Concerning urine cultures more specifically, some studies demonstrated that inadequate initial antimicrobial treatment could lead to longer duration of hospitalization. However, this association was mainly noted in non‐ E. coli urinary tract infections, in children with urinary or renal abnormalities, or in children who had received antimicrobial therapy in the previous month [18,19]. Similarly, a study conducted in a tertiary‐care hospital and a community hospital demonstrated a significant association between inadequate initial antimicrobial treatment and mortality in cases of infections due to extended‐spectrum β‐lactamase‐producing Enterobacteriaceae .…”

Section: Discussionmentioning

confidence: 99%

Assessment of the usefulness of performing bacterial identification and antimicrobial susceptibility testing 24 h a day in a clinical microbiology laboratory

Eveillard

Lemarié

Cottin

et al. 2010

Clinical Microbiology and Infection

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The impact of inoculating agar media with positive blood cultures and of performing bacterial identification and antimicrobial susceptibility testing (AST) for positive urine cultures, blood cultures and certain fluid cultures after day hours (night service (NS)) was evaluated in a clinical microbiology laboratory. The impact of the NS was assessed in terms of decreases in the delays from the time of sampling to the time at which results became available and of the consequences for patient management and antimicrobial treatment. Two major benefits were obtained: initiation of earlier appropriate treatment, and change to a reduced-spectrum but still efficient regimen. The hours of laboratory testing and the availability and transmission of results to the clinical staff were recorded. Concurrently, these hours were estimated as though laboratory tests had been performed in the absence of NS. Reductions in delay were defined as the differences between the hours actually spent and the estimated hours. Economic concerns were also considered. Overall, 430 samples for which an identification and/or AST were performed during the NS were included in the study. The NS led to the implementation of earlier appropriate therapy in 97 cases (22.6%), and to the change to reduced-spectrum but still efficient regimens in 23 additional cases (5.3%). In conclusion, there appeared to be benefits from a system providing bacterial identification and AST overnight, but a study of the cost-effectiveness of the NS would be useful to back up this observation.

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Community-Acquired Pseudomonas aeruginosa Urinary Tract Infections in Children Hospitalized in a Tertiary Center: Relative Frequency, Risk Factors, Antimicrobial Resistance and Treatment

Abstract: Pseudomonas UTI seems to increase in CA, hospital-treated children and is often treated inappropriately according to current treatment protocols. Awareness of this trend and knowledge of the defined risk factors of Pseudomonas UTI might improve the empiric antibiotic therapy.

Cited by 33 publications

References 22 publications

Antimicrobial Susceptibilities and Clinical Characterization of <b><i>Pseudomonas aeruginosa</i></b> Isolates from Urinary Tract Infections

Antimicrobial Susceptibilities and Clinical Characterization of <b><i>Pseudomonas aeruginosa</i></b> Isolates from Urinary Tract Infections

Community-acquired enterococcal urinary tract infections in hospitalized children

Assessment of the usefulness of performing bacterial identification and antimicrobial susceptibility testing 24 h a day in a clinical microbiology laboratory

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