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KMID : 1040320150220010029
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Pediatric Infection & Vaccine
2015 Volume.22 No. 1 p.29 ~ p.35
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Febrile Urinary Tract Infections Caused by Community-Acquired Extended-Spectrum β-Lactamase-Producing and-Nonproducing Bacteria: A Comparative Study
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Ahn Do-Hee
Kim Kyu-Won
Cho Hye-Kyung
Tchah Hann
Jeon In-Sang
Ryoo Eell
Sun Yong-Han
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Abstract
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Purpose: The purpose of this study was to investigate the clinical characteristics and outcome of febrile urinary tract infections (UTIs) caused by community-acquired extended-spectrum β-lactamase (CA-ESBL)-producing and -nonproducing bacteria.
Methods: We analyzed febrile UTIs in children hospitalized at Gachon University Gil Medical Center from January 2011 to December 2013 through retrospective data collection from their medical records.
Results: Among pathogens causing 374 episodes of UTIs, the proportion of ESBL-producing bacteria was 13.1% (49/374). The proportion of ESBL-producing Escherichia coli and Klebsiella spp. was 13.6% (48/354) and 5.0% (1/20), respectively. There was no significant difference between the CA-ESBL and CA non-ESBL groups in duration of fever (4.2±2.7 vs.3.7±2.1 days, P =0.10) and bacterial eradication rate with empirical antibiotics (100% vs. 100%). The risk of cortical defects on renal scan significantly depended on existence of vesicoureteral reflux rather than ESBL production of pathogen.
Conclusions: There was no significant difference between the CA-ESBL and CA non-ESBL groups in renal cortical defects and clinical outcome. Careful choice of antibiotics is important for treatment of community-acquired UTI in children.
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KEYWORD
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Urinary tract infection, Extended-spectrum β-lactamase
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