The change of antibiotic susceptibility in febrile urinary tract infection in childhood and adolescence during the last decade

Choi, Useok; Kim, Eunjae; Lyu, Don Hee; Kim, Kang Seob; Park, Bong Hee; Chung, Hong; Han, Chang Hee; Bae, Su Mi

doi:10.4111/icu.20210350

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…Several recently published studies describe the alarming trend of decreasing sensitivity to antibiotics [ 22 , 24 , 25 , 28 , 30 , 31 , 32 ]. We observed a significant growth in the percentage of E. coli strains classified as susceptible-increased exposure or resistant to cefuroxime.…”

Section: Discussionmentioning

confidence: 99%

Urinary Tract Infection and Antimicrobial Resistance Patterns: 5-Year Experience in a Tertiary Pediatric Nephrology Center in the Southwestern Region of Poland

Kawalec,

Józefiak,

Kiliś-Pstrusińska

2023

Antibiotics

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(1) Background: Urinary tract infections (UTIs) are among the most common infections in the pediatric population. This study aimed to analyze the urine culture results and antimicrobial patterns over the last 5 years in children diagnosed with UTI. (2) Methods: Retrospective analysis of medical records of 242 patients hospitalized in the Pediatric Nephrology Department diagnosed with a UTI in the years 2018–2022. (3) Results: The most common causative agent was E. coli, responsible for 64% of UTIs, followed by Klebsiella spp. (16%), Pseudomonas spp. (6%), Enterobacter spp. (4%), Proteus spp. (4%), and Enterococcus spp. (3%). Non-E. coli UTIs were significantly more frequently observed in patients with congenital anomalies of the kidney and urinary tract or neurogenic bladder and patients receiving antibiotic prophylaxis. For the whole study period, 32% of E. coli were resistant to amoxicillin/clavulanic acid, 23.3% to trimethoprim/sulfamethoxazole, 12.2% to ciprofloxacin, and 4.4% to nitrofurantoin. During 2018–2022, the prevalence of E. coli resistant to amoxicillin/clavulanic acid varied from 16.7% to 41.2%, and resistance to cefuroxime increased four times (from 4% in 2018 to 16.7% in 2022). Starting in 2021, all isolated E. coli strains were classified as susceptible-increased exposure or resistant to cefuroxime. (4) Conclusion: Managing pediatric UTIs remains challenging in clinical practice. The choice of optimal empiric treatment should be considered following local recommendations and individual risk factors assessment and require careful dosage adjustment. Observed changes in antimicrobial resistance indicated the need for frequent updating of local recommendations for the management of pediatric patients with UTIs.

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Section: Discussionmentioning

confidence: 99%

Urinary Tract Infection and Antimicrobial Resistance Patterns: 5-Year Experience in a Tertiary Pediatric Nephrology Center in the Southwestern Region of Poland

Kawalec,

Józefiak,

Kiliś-Pstrusińska

2023

Antibiotics

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Piperacillin−tazobactam versus cefotaxime as empiric treatment for febrile urinary tract infection in children

Han,

Oh,

Ahn

et al. 2023

Preprint

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Urinary tract infections (UTI) are one of the most common infections in children. The proportion of extended − spectrum beta − lactamase (ESBL) − producing bacteria in pediatric UTIs is increasing. Therefore, it is necessary to pay attention to the use of antibiotics to prevent ESBL − producing bacteria in patients susceptible to infections in medical institutions. This study aimed to investigate the clinical features related to the recurrence of UTI in children and to confirm the experience and validity of piperacillin − tazobactam (TZP) as a first − line treatment. Medical records of pediatric patients diagnosed with febrile UTI between January 2014 and February 2017 were retrospectively reviewed. Patients were grouped according to the antimicrobials they received. Clinical characteristics and treatment outcomes in terms of recurrent UTI were compared between the groups. Our findings demonstrate significant variations in the clinical characteristics of UTIs depending on the age of onset. Further, we found that 18.3% of community − acquired UTIs were caused by ESBL − positive bacteria. Regarding the empiric treatment for febrile UTI in children ≥ 3 months, there was no significant difference in recurrence between the cefotaxime − treated group and TZP − treated group. Thus, TZP can be considered an alternative to cefotaxime for febrile UTI in infants and children ≥ 3 months of age.

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The interplay between bacterial biofilms, encrustation, and wall shear stress in ureteral stents: a review across scales

Amado,

Zheng,

Lange

et al. 2024

Front. Urol.

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Ureteral stents are hollow tubes that are inserted into the ureter to maintain the flow of urine from the kidney to the bladder. However, the use of these indwelling stents is associated with potential complications. Biofilm, an organized consortium of bacterial species embedded within a self-producing extracellular matrix, can attach to the outer and inner surfaces of ureteral stents. Furthermore, encrustation - defined as the buildup of mineral deposits on the stent surface - can occur independently or in parallel with biofilm formation. Both phenomena can cause stent obstruction, which can lead to obstructive pyelonephritis and make stent removal difficult. Understanding the influence of flow on the development of biofilm and encrustation and the impact of small mechanical environmental changes (e.g., wall shear stress distribution) is key to improve the long-term performance of stents. Identifying the optimal stent properties to prevent early bacterial attachment and/or crystal deposition and their growth, would represent a breakthrough in reducing biofilm-/encrustation-associated complications. This review identifies the most prevalent bacterial strains and crystal types associated with ureteral stents, and the process of their association with the stent surface, which often depends on patient comorbidities, stent material, and indwelling time. Furthermore, we focus on the often-overlooked role of fluid dynamics on biofilm and encrustation development in ureteral stents, across a range of physical scales (i.e., from micro- to macro-scale) with the aim of providing a knowledge base to inform the development of safer and more effective ureteral stents.

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The change of antibiotic susceptibility in febrile urinary tract infection in childhood and adolescence during the last decade

Cited by 4 publications

References 24 publications

Urinary Tract Infection and Antimicrobial Resistance Patterns: 5-Year Experience in a Tertiary Pediatric Nephrology Center in the Southwestern Region of Poland

Urinary Tract Infection and Antimicrobial Resistance Patterns: 5-Year Experience in a Tertiary Pediatric Nephrology Center in the Southwestern Region of Poland

Piperacillin−tazobactam versus cefotaxime as empiric treatment for febrile urinary tract infection in children

The interplay between bacterial biofilms, encrustation, and wall shear stress in ureteral stents: a review across scales

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