Update of the EAU/ESPU guidelines on urinary tract infections in children

Hoen, Lisette A. ’t; Bogaert, Guy; Radmayr, Christian; Doğan, Hasan Serkan; Nijman, Rien J.M.; Quaedackers, Josine; Rawashdeh, Yazan F.; Sılay, Mesrur Selçuk; Tekgül, Serdar; Bhatt, Nikita; Stein, Raimund

doi:10.1016/j.jpurol.2021.01.037

Cited by 79 publications

(91 citation statements)

References 56 publications

(50 reference statements)

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“…11 Accordingly, diagnosis continues to rely on bacterial culture of urine samples. 6,9 In the present study, bacterial cultures were performed for all patients during hospitalization and for some patients during follow-up. Bladder urine samples for bacterial culture were also collected during DJC withdrawal.…”

Section: Discussionmentioning

confidence: 99%

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Pathogen distribution and risk factors for urinary tract infection in infants and young children with retained double-J catheters

et al. 2021

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Objectives To investigate the pathogens and potential risk factors for urinary tract infection (UTI) in patients with retained double-J catheters (DJCs). Methods In total, 107 infants and young children with DJCs were included in this retrospective analysis. Patients were included in the infection group (n = 30) or non-infection group (n = 77), according to UTI presence or absence. The species and characteristics of pathogens were investigated, and the clinical features of the patients were recorded for further analysis. Results Gram-negative bacilli were the most common causative pathogens (69.2%), among which Escherichia coli was most frequent (38.5%). The second most common causative pathogens were Gram-positive cocci (28.2%), among which Enterococcus faecalis was most frequent (10.3%). UTIs among patients in this study were associated with the following factors: catheter retention (long-term) (odds ratio [OR] = 2.514, 95% confidence interval [CI] = 1.176–5.373), sex (male) (OR = 2.966, 95% CI = 1.032–8.529), DJC retention (long-term) (OR = 1.869, 95% CI = 1.194–2.926), and DJC number (unilateral) (OR = 0.309, 95% CI = 0.103–0.922). Conclusions Infants and young children with DJCs were likely to experience UTIs, mainly caused by Gram-negative bacilli. Long-term catheter retention or DJC retention, male sex, and bilateral DJC retention were risk factors for UTI.

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Section: Discussionmentioning

confidence: 99%

“…UTI diagnostic criteria were based on European Association of Urology Guidelines on Paediatric Urology: UTI was defined as a bacterial colony count >10 5 colony-forming units/ mL. 9 Pathogen identification was performed using the BD Phoenix-100 automatic microbial identification analyzer (BD, Franklin Lakes, NJ, USA).…”

Section: Participants and Uti Assessmentmentioning

confidence: 99%

Pathogen distribution and risk factors for urinary tract infection in infants and young children with retained double-J catheters

et al. 2021

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“…under the acronym “the ESKAPE pathogens”, capable of “escaping” the bactericidal action of antibiotics [ 7 , 8 ]. This group of bacteria represents a challenge for empirical antibiotic treatment of complicated UTI [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Treatment of UTI begins immediately after a urine specimen for culture is collected and before the culture results are available and then changing to specific therapy based on uropathogens sensibility [ 9 , 10 , 11 , 12 ]. The treatment aims to eradicate the infection, prevent bacteriemia, relieve the symptoms, improve the clinical condition, avert complications, and prevent renal scarring [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Guidelines for empirical antibiotic treatment of complicated UTI recommend amoxicillin/clavulanic acid or cefotaxime/ceftriaxone administered intravenously and then switching to oral as soon as the clinical condition permits it. The treatment duration must be 10 days for pyelonephritis and 14 days for urosepsis [ 9 , 12 , 14 ]. Bacterial resistance is a public health issue all over the world.…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract

Isac

Basaca²,

Olariu

et al. 2021

Children

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Background: Urinary tract infections (UTI) are common in children worldwide. Congenital anomalies of kidney and urinary tract (CAKUT) increase the risk of UTI and consequently antibiotic resistance. Antibiotic resistance represents an important public health issue worldwide. We aimed to evaluate the local trend in terms of bacterial uropathogen resistance in the western part of Romania in children with CAKUT and UTI. Methods: 252 children with CAKUT were admitted to our hospital over a five-year period. Of them, 91 developed at least one UTI episode, with a total number of 260 positive urine cultures. We collected data about age at diagnosis of CAKUT, sex, origin environment, type and side of CAKUT, number of UTIs, type of uropathogen, and uropathogens antibiotic resistance. Results: Distribution of uropathogens was Escherichia coli (38.84%), Klebsiella spp. (21.15%), Enterococcus spp. (15.76%), Proteus spp. (8.07%), Pseudomonas spp. (8.07%), Enterobacter spp. (2.3%), other Gram-negative bacteria (2.3%), and other Gram-positive bacteria (3.45%). High antibiotic resistance was detected for ampicillin, amoxicillin, and second-generation cephalosporins. Escherichia coli presented high resistance for cefepime and ceftriaxone. Pseudomonas spp. remained susceptible to amikacin, quinolones, and colistin. Vancomycin, teicoplanin, linezolid, and piperacillin/tazobactam remained effective in treating Gram-positive UTI. Conclusions: High antibiotic resistance was identified for frequently used antibiotics. Lower antibiotic resistance was observed for some broad-spectrum antibiotics. Understanding uropathogens’ antibiotic resistance is important in creating treatment recommendations, based on international guidelines, local resistance patterns, and patient particularities.

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Morganella morganii: An unusual analysis of 11 cases of pediatric urinary tract infections

Shi

Chen

Yao

et al. 2022

Clinical Laboratory Analysis

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Update of the EAU/ESPU guidelines on urinary tract infections in children

Cited by 79 publications

References 56 publications

Pathogen distribution and risk factors for urinary tract infection in infants and young children with retained double-J catheters

Pathogen distribution and risk factors for urinary tract infection in infants and young children with retained double-J catheters

Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract

Morganella morganii: An unusual analysis of 11 cases of pediatric urinary tract infections

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