title: Urinary tract infections caused by extended-spectrum betalactamase-producing bacteria in children: a matched casecontrol study.
abstract: Extended-spectrum beta-lactamase (ESBL)-producing pathogens are emerging as a cause of urinary tract infections (UTI) worldwide. In this matched-case control study, clinical characteristics and associated risk factors for ESBL UTI were evaluated. In a total of 463 positive urine cultures, 48 (10.4%) (from 39 patients, 23 boys) were phenotypically ESBL-producing bacteria. The most frequently isolated microorganism was , followed by Klebsiella spp. and Enterobacter cloacae. Children with ESBL UTI (n=39) were on prophylaxis more (21% vs. 6%, p=0.01), had higher rates of urinary tract anomalies (36% vs. 10%, p=0.0007), presented abnormal 99m Tcdimercaptosuccinic acid (DMSA) findings (i.e. scars) (23% vs. 4%, p=0.001), and had longer hospitalization (9.8 vs. 7.4 days, p=0.004) compared to those with non-ESBL UTI (n=117). The recognition of risk factors for UTI caused by ESBL bacteria in children may aid in the identification of high-risk cases and may enable proper management of these patients.
authors.affiliation: Department of Pediatrics, Aristotle University, Hippokratio Hospital, Thessaloniki, Greece. yandot@med.auth.gr.
authors.forename: John
authors.initials: J
authors.lastname: Dotis
authors.forename: Nikoleta
authors.initials: N
authors.lastname: Printza
authors.forename: Alexandra
authors.initials: A
authors.lastname: Marneri
authors.forename: Dimos
authors.initials: D
authors.lastname: Gidaris
authors.forename: Fotios
authors.initials: F
authors.lastname: Papachristou
mesh_terms: D000900:Anti-Bacterial Agents; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000201:enzymology* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases