Efficacy of non-carbapenem antibiotics for pediatric patients with first febrile urinary tract infection due to extended-spectrum beta-lactamase-producing Escherichia coli

Abe, Yoshifusa; Inan-Erdogan, Işil; Fukuchi, Kunihiko; Wakabayashi, Hitomi; Ogawa, Yasuha; Hibino, Satoshi; Sakurai, Shunsuke; Matsuhashi, Kazuhiko; Watanabe, Yoshitaka; Hashimoto, Kaori; Ugajin, Kazuhisa; Itabashi, Kazuo

doi:10.1016/j.jiac.2017.04.006

Cited by 16 publications

(21 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Alguns autores apontam defesas locais, para além da elevada concentração atingida no sistema urinário para alguns antibióticos que são excretados na urina, como os principais facilitadores de uma evolução favorável nessas situações. 40,41 No entanto, há poucos estudos em idade pediátrica sobre a utilização destes antibióticos no tratamento das IU causadas por bactérias produtoras de ESBL.…”

Section: Discussionunclassified

“…A avaliação da resposta clínica deve também ser utilizada nas decisões terapêuticas após utilização do antibiótico in vivo. 41 Num estudo retrospetivo conduzido num hospital terciário da Finlândia, no período de 2007 a 2016, que englobou 34 crianças e adolescentes até aos 18 anos com IU causada por bactérias produtoras de ESBL, observou-se que 88% (n = 30) destas infeções foram tratadas com sucesso com cefalosporinas. 42 Adicionalmente, outro estudo retrospetivo realizado em Tóquio entre 2006 e 2016, que incluiu crianças com IU febril causadas por E. coli produtoras de ESBL, concluiu que 80% destas (n = 12/15) foram tratadas com sucesso com antibióticos não-carbapenemos.…”

Section: Discussionunclassified

“…42 Adicionalmente, outro estudo retrospetivo realizado em Tóquio entre 2006 e 2016, que incluiu crianças com IU febril causadas por E. coli produtoras de ESBL, concluiu que 80% destas (n = 12/15) foram tratadas com sucesso com antibióticos não-carbapenemos. 41 Recentemente, outros antibióticos não-carbapenemos tais como a fosfomicina, têm sido utilizados com sucesso no tratamento das IU causadas por bactérias produtoras de ESBL em adultos. Uma revisão sistemática publicada em 2010, concluiu que as cistites causadas por estas estirpes apresentaram uma boa resposta clínica à terapêutica com fosfomicina (93,8%, n = 75/80), nomeadamente em estirpes de E. coli.…”

Section: Discussionunclassified

See 2 more Smart Citations

Infeções Urinárias Causadas por Enterobacteriaceae Produtoras de β-Lactamases de Espetro Expandido Adquiridas na Comunidade num Hospital de Nível III - Um Estudo Retrospetivo

et al. 2020

View full text Add to dashboard Cite

Introduction: The emergence of β-lactamases producing bacteria is a problem worldwide, with increasing importance in communityacquired infections, especially in urinary tract infections. Data regarding the use of non-carbapenem antimicrobials in these infections are scarce. The aim of this study was to analyse the treatment and outcome of urinary tract infections caused by community-acquired β-lactamase-producing bacteria in children.Material and Methods: Retrospective study performed in a level III paediatric hospital, between June 2007 and December 2017. All children with β-lactamase-producing Enterobacteriaceae identified in aseptically collected urine culture were included.Results: A total of 175 urinary infections caused by β-lactamases producing bacteria were diagnosed, 34 (19%) were community-acquired: 25 Escherichia coli (74%), 4 Klebsiella pneumoniae (12%), 4 Proteus mirabilis (12%) and 1 Proteus vulgaris (3%). In 30 (88%) cases, it was the first urinary infection. After identification of the microorganism and antimicrobial susceptibility, 33 (97%) children were re-evaluated and 24 (71%) had a repeat urine culture, which was positive in three (13%). In six (18%) cases, antibiotic treatment was modified. Four (12%) children had another UTI in the following month. In 30 (88%) children, imaging was carried out, with no nephrourological malformations detected.Discussion: In the last decade, about 20% of urinary infections caused by β-lactamase-producing Enterobacteriaceae were community-acquired with a relatively stable number of cases over the years. No nephro-urological malformations were identified in these children.Conclusion: Although the number of cases is small, the clinical and microbiological outcomes showed that most were successfully treated with non-carbapenem antibiotics, with low recurrence of new episodes of urinary tract infections.

show abstract

Section: Discussionunclassified

See 1 more Smart Citation

Infeções Urinárias Causadas por Enterobacteriaceae Produtoras de β-Lactamases de Espetro Expandido Adquiridas na Comunidade num Hospital de Nível III - Um Estudo Retrospetivo

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Two previous retrospective studies showed that the initial empiric antibiotic therapy for pediatric UTIs caused by ESBL did not worsen the outcome, and the authors concluded that switching to appropriate antibiotics after detection of ESBL-producing microorganisms was sufficient [ 17 , 18 ]. The efficacy of non-carbapenem antibiotics such as amikacin, fosfomycin, cefmetazole, and flomoxef for UTIs with ESBL-producing bacteria has been reported [ 9 , 15 , 19 ]. However, the efficacy of antibiotics other than carbapenem for blood culture-positive UTIs caused by ESBL-producing pathogens among children is unknown.…”

Section: Discussionmentioning

confidence: 99%

Renal abscess with bacteremia caused by extended-spectrum β-lactamase-producing Escherichia coli: a case report

et al. 2020

View full text Add to dashboard Cite

Background Renal abscess in children is a rare and severe form of infectious kidney disease that is responsible for several serious complications. In this report, we describe a previously healthy 5-year-old girl with a renal abscess caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli), which led to bacteremia and renal scarring. Case presentation The patient presented to our department with high fever, headache, vomiting for 2 days and high inflammatory response. We diagnosed her with a urinary tract infection and initiated treatment with ampicillin and cefotaxime. Gram-negative bacilli bacteremia was noted on day 3. On day 4, her fever persisted, and a computed tomography (CT) scan revealed a renal abscess in the left kidney. After identifying the bacteria as ESBL-producing E. coli from the blood culture, we switched to the antibiotic meropenem and continued treatment for 3 weeks. The renal abscess was not drained. Although the renal abscess was successfully treated and it disappeared, a low-density area remained in same lesion on subsequent CT scans and a dimercaptosuccinic acid renal scan performed 4 months after onset revealed renal scarring. Conclusion Given the increasing prevalence of ESBL-producing microorganisms, clinicians should be aware of the possibility of renal abscesses caused by community-acquired ESBL-producing organisms even in previously healthy children. Once a renal abscess is suspected, early diagnosis and management are important for reducing the risk of life-threating complications and renal scarring.

show abstract

“…23,24) Treatment failure or relapse rates between patients who were administered a non-carbapenem for ESBL-producing eGNRs did not differ compared to those administered a carbapenem. 23,24) In this study, patients without VUR also showed similar results, with no treatment failure and low short term recurrences. However, when further investigating patients with underlying VUR, patients who had fUTI caused by an ESBL producer had a significantly higher short term recurrence rate than those with non-ESBL-…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

Febrile urinary tract infection in children: changes in epidemiology, etiology, and antibiotic resistance patterns over a decade

et al. 2021

View full text Add to dashboard Cite

Background: Understanding the epidemiology and prevalence of febrile urinary tract infection (fUTI) in children is important for risk stratification and selecting appropriate urine sample collection candidates to aid in its diagnosis and treatment. Purpose: This study aimed to analyze the epidemiology, etiology, and changes in antibiotic susceptibility patterns of the first fUTI in children. Methods: This retrospective observational cohort study included children younger than 19 years of age who were diagnosed and treated for their first fUTI in 2006-2016. Electronic medical records were analyzed and radiologic images were evaluated. Results: A total of 359 patients (median age, 5.1 [interquartile range, 3.0-10.5] months) fit the inclusion criteria; of them, 78.0% (n = 280) were younger than 12 months old. The male to female ratio was 5.3:1 for patients aged 0-2 months, 2.1:1 for those 3-5 months, and 1.6:1 for those 6-11 months. Beyond 12 months of age, there was a female predominance. Escherichia coli was the leading cause (83.8%), followed by Enterococcus species (6.7%) and Klebsiella pneumoniae (3.6%). Significant yearly increases in the proportions of multidrug-resistant strains (p < 0.001) and extended-spectrum beta-lactamase (ESBL) producers (p < 0.001) were observed. In patients with vesicoureteral reflux, the overall recurrence rate was 53.6% (n = 15). A significantly higher recurrence rate was observed when the fUTI was caused by an ESBL versus non-ESBL producer (75.0% vs. 30.0%, p = 0.03). Conclusion: FUTI was most prevalent in children younger than 12 months of age and showed a female predominance in patients older than 12 months of age. The proportion of ESBL producers causing fUTI is increasing. Carbapenems, rather than non-carbapenems, should be considered for treating fUTI caused by ESBL-producing enteric gram-negative A c c e p t e d A r t i c l e rods to reduce short-term recurrence rates.

show abstract

Efficacy of non-carbapenem antibiotics for pediatric patients with first febrile urinary tract infection due to extended-spectrum beta-lactamase-producing Escherichia coli

Cited by 16 publications

References 24 publications

Infeções Urinárias Causadas por Enterobacteriaceae Produtoras de β-Lactamases de Espetro Expandido Adquiridas na Comunidade num Hospital de Nível III - Um Estudo Retrospetivo

Infeções Urinárias Causadas por Enterobacteriaceae Produtoras de β-Lactamases de Espetro Expandido Adquiridas na Comunidade num Hospital de Nível III - Um Estudo Retrospetivo

Renal abscess with bacteremia caused by extended-spectrum β-lactamase-producing Escherichia coli: a case report

Febrile urinary tract infection in children: changes in epidemiology, etiology, and antibiotic resistance patterns over a decade

Contact Info

Product

Resources

About