title: Emergence of antimicrobial-resistant uropathogens isolated from pediatric patients with cystitis on daily clean intermittent catheterization.
abstract: One of the major complications of clean intermittent catheterization (CIC) is urinary tract infection (UTI). Recent reports showed that community-acquired UTIs caused by antimicrobial-resistant pathogens were gradually presenting in adults. However, there have been few reports about UTIs caused by antimicrobial-resistant bacteria in pediatric patients. Therefore, we retrospectively reviewed the medical charts of 45 children with CIC due to neurogenic bladder dysfunction from January 2010 to March 2013. Sixty-two episodes of cystitis occurred in 27 patients. Seventy bacterial strains were isolated from urine samples. The rate of Gram-negative bacteria was 84.3%. Six extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) strains were isolated from 4 patients. An ESBL-producing Proteus mirabilis strain and a methicillin-resistant Staphylococcus aureus strain were isolated from one patient each. Most of the pathogens of cystitis in the pediatric patients with CIC were Gram-negative bacilli, especially E. coli. We should be aware that ESBL producing E. coli as potential pathogens cause cystitis and regularly survey antimicrobial susceptibility to understand the resistant strains that develop.
authors.affiliation: Department of Urology, Hokkaido Medical Center for Child Health and Rehabilitation, 1-240-6, kanayama 1-jo, Teine-ku, Sapporo, 006-0041, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hiyama
authors.affiliation: Department of Urology, Hokkaido Medical Center for Child Health and Rehabilitation, 1-240-6, kanayama 1-jo, Teine-ku, Sapporo, 006-0041, Japan. Electronic address: stakahas@sapmed.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Urology, Hokkaido Medical Center for Child Health and Rehabilitation, 1-240-6, kanayama 1-jo, Teine-ku, Sapporo, 006-0041, Japan.
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Uehara
authors.affiliation: Department of Urology, Hokkaido Medical Center for Child Health and Rehabilitation, 1-240-6, kanayama 1-jo, Teine-ku, Sapporo, 006-0041, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Hashimoto
authors.affiliation: Department of Pediatric Urology, Hokkaido Medical Center for Child Health and Rehabilitation, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nishinaka
authors.affiliation: Department of Urology, Hokkaido Medical Center for Child Health and Rehabilitation, 1-240-6, kanayama 1-jo, Teine-ku, Sapporo, 006-0041, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitamura
authors.affiliation: Department of Urology, Hokkaido Medical Center for Child Health and Rehabilitation, 1-240-6, kanayama 1-jo, Teine-ku, Sapporo, 006-0041, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Masumori
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000209:etiology*; D004352:Drug Resistance, Microbial; D004866:Equipment Contamination; D004927:Escherichia coli Infections / Q000150:complications* / Q000382:microbiology*; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D057928:Intermittent Urethral Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000150:complications* / Q000382:microbiology*; D001618:beta-Lactamases
chemical_list: D001618:beta-Lactamases
keywords: Child; Clean intermittent catheterization; Cystitis; Escherichia coli; Extended-spectrum β-lactamase; Urinary tract infection