Trends in Antimicrobial Susceptibility of Escherichia coli Isolates in a Taiwanese Child Cohort with Urinary Tract Infections between 2004 and 2018

Abstract

The aim of this study was to investigate the annual incidence of Escherichia coli isolates in urinary tract infections (UTIs) and the antimicrobial resistance of the third-generation cephalosporin (3GCs) to E. coli, including the factors associated with the resistance in hospitalized children in Taiwan. A large electronic database of medical records combining hospital admission and microbiological data during 2004–2018 was used to study childhood UTIs in Taiwan. Annual incidence rate ratios (IRR) of E. coli in children with UTIs and its resistant rate to the 3GCs and other antibiotics were estimated by linear Poisson regression. Factors associated with E. coli resistance to 3GCs were assessed through multivariable logistic regression analysis. E. coli UTIs occurred in 10,756 unique individuals among 41,879 hospitalized children, with 92.58% being community associated based on urine culture results reported within four days after the hospitalization. The overall IRR E. coli UTI was 1.01 (95% confidence interval (CI) 0.99–1.02) in community-associated (CA) and 0.96 (0.90–1.02) in healthcare-associated infections. The trend in 3GCs against E. coli increased (IRR 1.18, 95% CI 1.13–1.24) over time in CA-UTIs. Complex chronic disease (adjusted odds ratio (aOR), 2.04; 95% CI, 1.47–2.83) and antibiotics therapy ≤ 3 months prior (aOR, 1.49; 95% CI, 1.15–1.94) were associated with increased risk of 3GCs resistance to E. coli. The study results suggested little or no change in the trend of E. coli UTIs in Taiwanese youths over the past 15 years. Nevertheless, the increase in 3GCs-resistant E. coli was substantial. Interventions for children with complex chronic comorbidities and prior antibiotic treatment could be effective in reducing the incidence of 3GCs-resistant E. coli in CA-UTIs in this region and more generally.

Bacterial profile and antibiotic susceptibility pattern of uropathogens causing urinary tract infection in the eastern part of Northern India

“…The most common gram-negative bacteria isolated from samples in our investigation was E. coli (55.0%). These findings are consistent with those of several other published studies where the prevalence of E. coli was 97.0, 92.6, 74.0, 55.0, 49.3, 43.5, 41.9, and 40.0% (Arora et al, 2016;Odoki et al, 2019;Chen et al, 2020;Daoud et al, 2020;Ali et al, 2022;Huang et al, 2022;Jagadeesan et al, 2022;Komagamine et al, 2022). In our study, 10.3389/fmicb.2022.965053…”

Molecular Characterization of Extended Spectrum β-Lactamase (ESBL) and Virulence Gene-Factors in Uropathogenic Escherichia coli (UPEC) in Children in Duhok City, Kurdistan Region, Iraq

“…This study revealed that E. coli was the predominant uropathogen in children in our community, where the prevalence of the infected girls was higher than in boys. These findings were in agreement with the recent results obtained by several studies in Iraq, in Duhok city [ 35 ], Erbil city [ 36 , 37 ], and Baghdad city [ 38 ], as well as a Child Cohort Study in Taiwan with UTIs between 2004 and 2018 [ 39 ]. In fact, there are many factors that can affect the interpretation of UTIs in girls, particularly E. coli .…”

Evaluating the Bacteria Profile and Drug Susceptibility Patterns of Urinary Tract Infectious Pathogens in Pregnant Women in Abakaliki Metropolis, Nigeria

“…Among pregnant women, E. coli 13.5% was the most predominant bacteria and is in line with other studies in different parts of the world [25,26,27,28,29,30,31,32]. The high predominant rate of E. coli might be due to the high abundance of E. coli as fecal flora, which ascends through the genitalia to cause UTI [33].…”