Predictive factors of urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli in children: a prospective Tunisian study.

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Published Jul 11, 2023
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Vol. 101 No. 2 (2023): Issue Feb 2023

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Abir Boussetta
Service de pédiatrie, Hôpital Charles Nicolle / Université de Tunis El Manar, Faculté de médecine de Tunis
Nouha Kharbach
Service de pédiatrie, Hôpital Charles Nicolle / Université de Tunis El Manar, Faculté de médecine de Tunis
Abir Abdellatif
Service de pédiatrie, Hôpital Charles Nicolle / Université de Tunis El Manar, Faculté de médecine de Tunis
Amina Karray
Service d’urologie, Hôpital Charles Nicolle / Faculté de médecine de Tunis
Manel Jellouli
Service de pédiatrie, Hôpital Charles Nicolle / Université de Tunis El Manar, Faculté de médecine de Tunis
Tahar Gargah
Service de pédiatrie, Hôpital Charles Nicolle / Université de Tunis El Manar, Faculté de médecine de Tunis

Abstract

Aim: To identify the predictive factors for the occurrence of community-acquired urinary tract infections caused by Extended-Spectrum
β-Lactamase-Producing Escherichia coli in children.
Methods: This was a single-center prospective observational study of children and young adults with community-acquired urinary tract
infections caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli. The study was conducted in the pediatric nephrology
department in Charles Nicolle Hospital, Tunis, Tunisia from January 1st, 2019, to December 31, 2020. Patients ≤20 years with community-acquired urinary tract infection caused by Escherichia coli were included prospectively in our study.
Results: We collected 290 urinary tract infections in 218 patients, including 92 urinary tract infections due to Extended-Spectrum β-Lactamase-Producing Escherichia coli. The mean age of children was 50.10±54.28 months, with a female predominance in 65.2% of cases.
Risk factors for the acquisition of multidrug-resistant bacteria were antibiotic therapy in the previous three months, antibiotic prophylaxis,
hospitalization in the year preceding the urinary tract infections, and outpatient care in the previous six months (p<0.05). Resistance to
Ceftazidime, Cefotaxime, Cefixime, Gentamicin and Ofloxacin was significantly associated with the presence of an Extended-Spectrum
β-Lactamase strain. Antibiotic resistance was significantly more observed in the age group above 6 years. Co-habitation with health care
worker was a risk factor for resistance to Amoxicillin-Clavulanic Acid. Understanding the epidemiological profile and risk factors for ESBL-producing UTIs, including Extended-Spectrum β-Lactamase-producing Escherichia coli in the pediatric population, could improve the
therapeutic approach and lead to more rational prescription of antibiotics.

Keywords:

Child, Urinary tract infection, Escherichia coli, Extended spectrum beta lactamases, Antibiotics

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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