Prevalence of ESBL-producing Enterobacteriaceae in paediatric urinary tract infections: A systematic review and meta-analysis

Flokas, Myrto Eleni; Detsis, Marios; Alevizakos, Michail; Mylonakis, Eleftherios

doi:10.1016/j.jinf.2016.07.014

Cited by 90 publications

(95 citation statements)

References 46 publications

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“…There were no significant differences in the clinical presentation between ESBL‐UTI and non‐ESBL‐UTI, similar to previous studies, apart from longer hospital stay in the ESBL group, as demonstrated in other studies . This can be attributed to limitation in the availability of oral therapy in these patients and delay in initiating the appropriate antimicrobial therapy while waiting on urine culture results.…”

Section: Discussionsupporting

confidence: 87%

“…from Lebanon that evaluated hospitalized children over a 10 year period, reported an ESBL positivity rate of 15.5% . A recent systematic review and meta‐analysis on ESBL‐producing enterobacteriaceae in pediatric UTI noted a pooled prevalence of pediatric ESBL‐UTI of 5% in eastern Mediterranean studies compared with an overall prevalence of 14% in all other countries …”

Section: Discussionmentioning

confidence: 99%

“…Isolation of ESBL‐producing bacteria has typically occurred in the hospital setting, but they have begun to disseminate into the community and the incidence of pediatric community‐acquired UTI caused by ESBL organisms (CA‐ESBL‐UTI)) is rising worldwide . A recent systematic review and meta‐analysis has shown a 14% pooled prevalence of pediatric UTI caused by ESBL‐producing enterobacteriaceae in different countries . Several limited studies have described the risk factors for CA‐ESBL‐UTI in children .…”

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confidence: 99%

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Urinary tract infection caused by extended‐spectrum β‐lactamase‐producing bacteria: Risk factors and antibiotic resistance

Albaramki

Abdelghani

Dalaeen

et al. 2019

Pediatrics International

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Background The aim of this study was to investigate the risk factors for acquisition of extended spectrum β‐lactamase (ESBL)‐producing bacteria in community‐acquired urinary tract infection (UTI) and to evaluate their antimicrobial resistance. Methods The medical records of hospitalized children were retrospectively evaluated. Children with ESBL‐producing bacteria UTI were matched with controls with non‐ESBL‐producing bacteria UTI of the same age and gender. Results A total of 243 patients with community‐acquired UTI in a 5 year period were evaluated, of whom 46% had UTI caused by ESBL bacteria. Seventy‐seven cases were matched with 77 controls. There were no significant differences in the clinical presentation between the two groups apart from a longer hospital stay in the ESBL group (9.1 ± 5.5 days vs 8.0 ± 4.4 days, P = 0.013). Significant potential risk factors for ESBL‐UTI were previous use of antibiotics in the last 3 months, previous hospitalization in the last 3 months, history of recurrent UTI, and presence of renal anomalies. On logistic regression analysis, history of previous hospitalization in the last 3 months (OR, 3.83; 95%CI: 1.49–9.84) was identified as an independent significant risk factor for ESBL‐UTI. There was a significantly higher resistance to amoxicillin‐clavulanate, amikacin, gentamycin and quinolones in the ESBL group compared with the control group. Conclusion Recognizing the risk factors for ESBL‐UTI helps to identify the high‐risk cases and enables proper management.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Urinary tract infection caused by extended‐spectrum β‐lactamase‐producing bacteria: Risk factors and antibiotic resistance

Albaramki

Abdelghani

Dalaeen

et al. 2019

Pediatrics International

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“…Knowledge of the etiological agent of UTIs and their antimicrobial resistance patterns in our setting may help clinicians in choosing the appropriate antimicrobial treatment. Moreover, most of the studies on pediatric urinary tract infections caused by multidrug resistant and ESBL producing bacteria have been reported from western world [10, 13], but the same from South Asian region including Nepal are scarce on the published literature [14]. In this perspective, the present study was designed to investigate the clinical isolates of multi-drug resistant and ESBL producing Escherichia coli causing urinary tract infections in children visiting a tertiary care teaching hospital in Nepal.…”

Section: Introductionmentioning

confidence: 99%

High rates of multidrug resistance among uropathogenic Escherichia coli in children and analyses of ESBL producers from Nepal

Parajuli

Maharjan

Parajuli

et al. 2017

Antimicrob Resist Infect Control

132

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BackgroundEmergence of Extended-spectrum beta-lactamase producing Escherichia coli causing urinary tract infections (UTI) among pediatric patients is an increasing problem worldwide. However, very little is known about pediatric urinary tract infections and antimicrobial resistance trend from Nepal. This study was conducted to assess the current antibiotic resistance rate and ESBL production among uropathogenic Escherichia coli in pediatric patients of a tertiary care teaching hospital of Nepal.MethodsA total of 5,484 urinary tract specimens from children suspected with UTI attending a teaching hospital of Nepal over a period of one year were processed for the isolation of bacterial pathogens and their antimicrobial susceptibility testing. Escherichia coli (n = 739), the predominant isolate in pediatric UTI, was further selected for the detection of ESBL-production by phenotypic combination disk diffusion test.ResultsIncidence of urinary tract infection among pediatric patients was found to be 19.68% and E coli (68.4%) was leading pathogen involved. Out of 739 E coli isolates, 64.9% were multidrug resistant (MDR) and 5% were extensively drug resistant (XDR). Extended spectrum beta lactamase (ESBL) was detected in 288 (38.9%) of the E coli isolates.ConclusionAlarming rate of drug resistance among pediatric uropathogens and high rate of ESBL-producing E. coli was observed. It is extremely necessary to routinely investigate the drug resistance among all isolates and formulate strict antibiotics prescription policy in our country.

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“…Moreover, the aetiology of UTI and the pattern of antibiotic resistance have been changing over the past years. 9 Most of the studies on paediatric urinary tract infections caused by multidrug resistant bacteria have been done in western world 10,11 , but these types of studies are scarce in South Asian region. 12 However, there are not much information on aetiology and resistance pattern of community acquired UTIs in Bangladesh.…”

Section: Introductionmentioning

confidence: 99%

Bacterial Aetiology and Antibiotic Resistance Pattern of Community-Acquired Urinary Tract Infections in Children in a Tertiary Care Hospital in Bangladesh

Sharmin¹,

Akter²

2017

J Enam Med Col

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Prevalence of ESBL-producing Enterobacteriaceae in paediatric urinary tract infections: A systematic review and meta-analysis

Cited by 90 publications

References 46 publications

Urinary tract infection caused by extended‐spectrum β‐lactamase‐producing bacteria: Risk factors and antibiotic resistance

Urinary tract infection caused by extended‐spectrum β‐lactamase‐producing bacteria: Risk factors and antibiotic resistance

High rates of multidrug resistance among uropathogenic Escherichia coli in children and analyses of ESBL producers from Nepal

Bacterial Aetiology and Antibiotic Resistance Pattern of Community-Acquired Urinary Tract Infections in Children in a Tertiary Care Hospital in Bangladesh

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