Resistant bacteria cause urinary tract infection in graduates of neonatal unit

Abstract

Pattern of bacteria that causes urinary tract infection (UTI) in infants after discharge from neonatal intensive care units (NICU) are not well described. This Study included 74 patients with first episodes of UTI in the first 3 months of life. They were divided into 2 groups, 31 case occurred during NICU stay (group 1), 43 cases with UTI that occurred after discharge from NICU (group 2, NICU graduates). Types of bacteria, its susceptibility to common antibiotics, renal abnormalities and circumcision status were compared between both groups. Eighty two percent of patients in the both groups were male. Between 71.9%-74.4% of patients in both groups were preterm. Among NICU graduates, Incidence of UTI in infants who were preterm and those who were term was 8.2% and 2.1% respectively p < 0.001. The most common causative bacteria in both groups were Klebsiella pneumoniae and Escherichia coli. Bacteria that caused UTI in NICU graduates were highly resistant to common antibiotics and were similar (in types and the resistance) to bacteria that caused UTI in patients during stay in NICU. UTI in NICU graduates happen frequently in premature, young male infants. Their UTI were caused by bacteria that are similar in type and resistant pattern to those cause UTI in NICU patients.

A Narrative Review of Healthcare-Associated Gram-Negative Infections Among Pediatric Patients in Middle Eastern Countries

“…Four studies from Levant countries were included in the review: two studies conducted in Jordan [ 55 , 56 ] and two in Lebanon [ 57 , 58 ] (Supplementary Table S4). No studies from Iraq met the inclusion criteria.…”

“…Both studies from Jordan were conducted in NICUs [ 55 , 56 ]. One study characterized a total of 68 isolates of pathogens causing sepsis in the NICU of a hospital in northern Jordan [ 55 ].…”

“…Sepsis caused by A. baumannii and KPC-producing K. pneumoniae was significantly associated with higher mortality (75% versus 26%, P = 0.001). The other study investigated UTIs in infants who were admitted to a single NICU at < 3 months of age [ 56 ]. Overall, 31 out of 1075 infants (3%) had a UTI during their NICU stay, and 5% developed a UTI ≥ 7 days after discharge.…”

“…Among studies that reported the prevalence of GNB pathogens, Klebsiella spp./K. pneumoniae (up to 40% of UTIs in infants) and E. coli (up to 79% of UTIs in children \ 18 years of age) were the most common GNB-causing infections [56][57][58]. All four studies reported AMR, with two reporting carbapenem resistance [55][56][57][58].…”