Urinary tract infections in children &lt; 2 years of age hospitalized in a tertiary medical center in Southern Israel: epidemiologic, imaging, and microbiologic characteristics of first episode in life

Shaki, David; Hodik, Gabriel; Elamour, Siham; Nassar, Raouf; Kristal, Eyal; Leibovitz, Ron; Horev, Amir; Leibovitz, Eugene

doi:10.1007/s10096-019-03810-w

Cited by 8 publications

(8 citation statements)

References 25 publications

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“…The proportion was lower than previous studies from West Asia and Europe (50-57%) (Alberici et al, 2015;Gurevich et al, 2016); thus, high proportion of non-E. coli uropathogens in newborns should be noticed when considering appropriate treatment. The percentage of E. coli increased with age while the percentage of E. faecium decreased with age, which was in accordance with a previous study (Shaki et al, 2020). The resistance rate of E. faecium was high to multiple available antibiotics in both newborn and pediatric, except vancomycin, linezolid, and teicoplanin.…”

Section: Discussionsupporting

confidence: 91%

“…The resistance rates of carbapenems, piperacillin-tazobactam, and nitrofurantoin were < 5% in E. coli overall (Figure 2); thus, these drugs could be used for empirical treatment of UTI, which was similar from the study of Southwest China (Sun et al, 2020). The resistance rate of K. pneumoniae was more serious compared with E. coli (Figure 3) while the study from Southern Israel in children showed similar resistance rate of K. pneumoniae and E. coli (Shaki et al, 2020), probably due to the geographic difference. The resistance rates of cephalosporins, fluoroquinolones, and carbapenems were higher in adult than in geriatric (p < 0.05).…”

Section: Discussionsupporting

confidence: 52%

“…proportions decreased with age, with the average percentages of 56.9, 14.1, and 11%, respectively. However, the data of adults were different from children to some extent (Bitew et al, 2017;Chu and Lowder, 2018;Shaki et al, 2020). Thus, the etiological profile and antibiotic susceptibility may change with age.…”

Section: Discussionmentioning

confidence: 92%

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Urinary Tract Infection Etiological Profiles and Antibiotic Resistance Patterns Varied Among Different Age Categories: A Retrospective Study From a Tertiary General Hospital During a 12-Year Period

Huang

Yan

et al. 2022

Front. Microbiol.

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BackgroundUrinary tract infections (UTIs) are among the most common infections worldwide. With continuing trends of antibiotic resistance, the etiological distribution and antibiotic susceptibility surveillance are of great importance for empirical antimicrobial therapy. The risk factors and clinical circumstances of UTI among different age categories varied; thus, the pathogens and antimicrobial susceptibilities of UTI may also change with age. The aim of this study was to compare the etiological profiles and antibiotic resistance patterns of UTIs sorted by different age categories from a tertiary general hospital during a 12-year period.MethodsAll positive urine culture results from non-repetitive UTI patients in our hospital from January 2009 to December 2020 were collected retrospectively. The microbial distribution and antibiotic resistance rates were analyzed by WHONET 5.6 software. The etiological profiles sorted by different age categories (newborn, pediatric, adult, and geriatric) and antibiotic resistance rates of the top five pathogens were analyzed.ResultsA total of 13,308 non-repetitive UTI patients were included in our study. Enterococcus faecium was dominant in newborn (45%, n = 105), and replaced by Escherichia coli in pediatric (34%, n = 362), adult (43%, n = 3,416), and geriatric (40%, n = 1,617), respectively. The etiological profiles of different age categories were divergent, sorted by genders (male and female) and ward types (outpatient, inpatient, ICU, and emergency). E. coli, Klebsiella pneumoniae, Enterococcus faecalis, E. faecium, and Pseudomonas aeruginosa were the top five pathogens in all age categories. The resistance rates of cefoperazone–sulbactam and piperacillin–tazobactam in E. coli were low in all age categories. The resistance rates of other cephalosporins, carbapenems, and fluoroqinolones in K. pneumoniae were higher in geriatric patients overall. E. faecium was more resistant than E. faecalis in all age categories. Multidrug resistance increased with age, which was more serious in geriatric patients.ConclusionThe UTI etiological profiles and antibiotic resistance patterns varied among different age categories, especially in pediatric and geriatric patients; thus, a different antibiotic therapy for various age categories should be considered when initiating empirical antimicrobial therapies.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 52%

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Urinary Tract Infection Etiological Profiles and Antibiotic Resistance Patterns Varied Among Different Age Categories: A Retrospective Study From a Tertiary General Hospital During a 12-Year Period

Huang

Yan

et al. 2022

Front. Microbiol.

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“…The proportion was lower than previous studies from West Asia and Europe (50%-57%) [18,19], thus high proportion of non-E. coli uropathogens in newborns should be noticed when considering appropriate treatment. The percentage of Escherichia coli increased with age while the percentage of Enterococcus faecium decreased with age, which was in accordance with previous study [14]. The resistance rate of Enterococcus faecium was high to multiple available antibiotics in both newborn and pediatric, except vancomycin, linezolid, and teicoplanin.…”

Section: Discussionsupporting

confidence: 91%

“…and Enterococcus spp. proportions decreased with age, with the average percentages of 56.9%, 14.1%, and 11%, respectively [14]. While the data of adults were different from children to some extent [6,8,9].…”

Section: Discussionmentioning

confidence: 99%

Differential Etiological Profiles and Antibiotic Resistance Patterns of Urinary Tract Infection Among Different Age Categories: A Retrospective Study from a Tertiary General Hospital During a 12-Year Period

Huang¹,

Huang²,

Yan³

et al. 2021

Preprint

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Background: Urinary tract infections (UTIs) are among the most common infections worldwide. With continuing trends of antibiotic resistance, the etiological distribution and antibiotic susceptibility surveillance are of great importance for empirical antimicrobial therapy. However, the data may change with different ages. The aim of this study was to compare the etiological profiles and antibiotic resistance patterns of UTIs sorted by different age categories from a tertiary general hospital during a 12-year period.Methods: All positive urine culture results from non-repetitive UTI patients in our hospital from January 2009 to December 2020 were collected retrospectively. The microbial distribution and antibiotic resistance rates were analyzed by WHONET 5.6 software. The etiological profiles sorted by different age categories (newborn, pediatric, adult, and geriatric) and antibiotic resistance rates of the top 5 pathogens were analyzed.Results: A total of 13308 non-repetitive UTI patients were included in our study. Enterococcus faecium was dominant in newborn, and replaced by Escherichia coli in other age categories. The etiological profiles of different age categories were divergent, sorted by genders (male and female) and ward types (outpatient, in-patient, ICU, and emergency). Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Enterococcus faecium, and Pseudomonas aeruginosa were the top 5 pathogens in all age categories. The resistance rates of cefperazone-sulbactam and piperacillin-tazobactam in Escherichia coli were low in all age categories. The resistance rates of cephalosporins, carbapenems, and fluoroqinolones in Klebsiella pneumoniae were higher in geriatric patients overall. Enterococcus faecium was more resistant than Enterococcus faecalis in all age categories.Conclusions: The UTI etiological profiles and antibiotic resistance patterns were divergent among different age categories, thus different empirical antibiotic therapies should be considered for different ages.

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Conflicting views of physicians and surgeons concerning pediatric urinary tract infection: a comparative review

Hewitt,

Roebuck,

Montini

2023

Pediatr Radiol

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Background A first febrile urinary tract infection (UTI) is a common condition in children, and pathways of management have evolved over time. Objective To determine the extent to which pediatricians and surgeons differ in their investigation and management of a first febrile UTI, and to evaluate the justifications for any divergence of approach. Materials and methods A literature search was conducted for papers addressing investigation and/or management following a first febrile UTI in children published between 2011 and 2021. Searches were conducted on Medline, Embase, and the Cochrane Controlled Trials Register. To be eligible for inclusion, a paper was required to provide recommendations on one or more of the following: ultrasound (US) and voiding cystourethrogram (VCUG), the need for continuous antibiotic prophylaxis and surgery when vesicoureteral reflux (VUR) was detected. The authorship required at least one pediatrician or surgeon. Authorship was categorized as medical, surgical, or combined. Results Pediatricians advocated less imaging and intervention and were more inclined to adopt a “watchful-waiting” approach, confident that any significant abnormality, grades IV–V VUR in particular, should be detected following a second febrile UTI. In contrast, surgeons were more likely to recommend imaging to detect VUR (p<0.00001), and antibiotic prophylaxis (p<0.001) and/or surgical correction (p=0.004) if it was detected, concerned that any delay in diagnosis and treatment could place the child at risk of kidney damage. Papers with combined authorship displayed intermediate results. Conclusion There are two distinct directions in the literature regarding the investigation of an uncomplicated first febrile UTI in a child. In general, when presented with a first febrile UTI in a child, physicians recommend fewer investigations and less treatment, in contrast to surgeons who advocate extensive investigation and aggressive intervention in the event that imaging detects an abnormality. This has the potential to confuse the carers of affected children.

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Urinary tract infections in children < 2 years of age hospitalized in a tertiary medical center in Southern Israel: epidemiologic, imaging, and microbiologic characteristics of first episode in life

Cited by 8 publications

References 25 publications

Urinary Tract Infection Etiological Profiles and Antibiotic Resistance Patterns Varied Among Different Age Categories: A Retrospective Study From a Tertiary General Hospital During a 12-Year Period

Urinary Tract Infection Etiological Profiles and Antibiotic Resistance Patterns Varied Among Different Age Categories: A Retrospective Study From a Tertiary General Hospital During a 12-Year Period

Differential Etiological Profiles and Antibiotic Resistance Patterns of Urinary Tract Infection Among Different Age Categories: A Retrospective Study from a Tertiary General Hospital During a 12-Year Period

Conflicting views of physicians and surgeons concerning pediatric urinary tract infection: a comparative review

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