Extended-Spectrum Beta-Lactamase – Producing Enterobacteriaceae Causing Urinary Tract Infections in Children in Qatar

Abstract

Objectives: Urinary tract infections (UTI) in children are most frequently due to Enterobacteriaceae. Multidrug-resistant Escherichia coli including extended-spectrum beta-lactamase (ESBL) producing organisms are becoming more prevalent. The aim of this study was to describe a cohort of children with ESBL producing organism urinary tract infections and the organism susceptibility patterns.Methods: This retrospective study evaluated a cohort of children with ESBL-induced UTI, admitted to our Pediatric Emergency Centre during a 2.5-years period. Results:In a total of 633 patients with urinary tract infection, 115 (18.2%) grew Gram-negative urinary isolates with an ESBL strain. Among of them (80%) female, (25.2%) had urinary tract abnormalities and (4.3%) had neuromuscular disorders. The most common bacteria were E coli (77.4%) then Klebsiella pneumonia (14.8%). All of the ESBL organisms were sensitive to carbapenems, with 98.7% sensitive to Amikacin, and 83% sensitive to Gentamicin. Gentamicin was used in (56.5%), Amikacin (23.5%) and Ertapenem/Meropenem (20.0%) of cases. The duration of treatment was 5-7 days but two cases relapsed. Conclusion:The proportion of urinary tract infection induced by ESBL organisms was almost 1 in 5 of patients. Carbapenems and aminoglycoside remained the corner stone in treatment of the urinary tract infection by ESBL produced organisms with very high efficacy, most cases responded to treatment within 5-7 days of intravenous single antibiotic.