First UTI episode in life in infants <1 year of age: Epidemiologic, clinical, microbiologic and disease recurrence characteristics

Abstract

Background: To examine the epidemiologic and microbiologic characteristics of first and recurrent UTI in young infants. Methods: A retrospective study of all infants <1 year hospitalized during 2014e2017 with their first UTI and followed during their first year of life. Results: 191 infants were enrolled; 69 (36.12%) patients were <2 months and 32 (16.8%) developed R-UTI during the follow-up. The five most common uropathogens were Escherichia coli, Klebsiella spp., Enterococcus spp., Proteus mirabilis and Staphylococcus aureus. High resistance rates were recorded for ampicillin, amoxicillin/clavulanic acid, TMP/SMX, cefuroxime, ceftriaxone, piperacillin/tazobactam and gentamicin among E. coli and Klebsiella spp.; 29.15% E. coli and 42.9% Klebsiella spp. were ESBL-positive. 53.2% of recurrent UTI (R-UTI) episodes were diagnosed within 2 months after the initial UTI episode. E. coli (40.6%) and Klebsiella spp. (37.55) were the most frequent R-UTI pathogens. Twenty-five (78.1%) R-UTIs were caused by recurrent uropathogens representing new infections. Antibiotic resistance rates at recurrence were similar to those at initial UTI, except for a significant increase in E. coli and Klebsiella spp. resistance to piperacillin/tazobactam.

Treatment of UTIs in Infants &lt;2 Months: A Living Systematic Review

“…A total of 4 studies contained older children, and authors were unable to provide data specific to those <2 months of age. 7,10,31,32 Finally, 1 study was only published as an abstract without any outcome data. 33 Studies were published between 1978 and 2020 (Table 1) and reported on a median sample size of 143.5 (range: 12-3973) participants per study.…”