TY - JOUR
T1 - Urinary tract infections in children < 2 years of age hospitalized in a tertiary medical center in Southern Israel
T2 - epidemiologic, imaging, and microbiologic characteristics of first episode in life
AU - Shaki, David
AU - Hodik, Gabriel
AU - Elamour, Siham
AU - Nassar, Raouf
AU - Kristal, Eyal
AU - Leibovitz, Ron
AU - Horev, Amir
AU - Leibovitz, Eugene
N1 - Publisher Copyright: © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - The objectives of the study were to describe the epidemiologic, microbiologic, and imaging characteristics of first 44 UTI episode in hospitalized infants and children < 2 years of age. A UTI episode was diagnosed based on suprapubic aspiration or urinary catheterization and report of a significant bacterial growth of true uropathogens. Two thousand two hundred ninety-four UTI episodes were recorded during 2009–2013 in 1694 patients; 1350 (79.7%), 223 (13.2%), and 66 (3.9%) had one, two, and three episodes, respectively. Of 1955 pathogens isolated, the most frequent were E. coli, Klebsiella spp., and Enterococcus spp. (56.9%, 14.1%, and 11%, respectively). E. coli percentages increased with increase in patient age while Klebsiella spp. and Enterococcus spp. decreased with decrease in age. 136/344 (39.5%) renal ultrasound examinations performed were reported abnormal. The percentages of abnormal ultrasound examinations in Enterococcus spp.-UTI were higher than in E. coli and Klebsiella spp.-UTI (P < 0.001 and P = 0.007, respectively). The E. coli nonsusceptibility to ampicillin, TMP/SMX, ceftriaxone, amoxicillin/clavulanic acid, cefuroxime, and gentamicin was 71%, 31%, 14.9%, 14.7%, 7%, and 4.4%, respectively. Nonsusceptibility of Klebsiella spp. to ampicillin, amoxicillin/clavulanic acid, TMP/SMX, ceftriaxone, gentamicin, and cefuroxime was 98.7%, 10.4%, 9.5%, 8.4%, 4.8%, and 4.3%, respectively. E. coli nonsusceptibility to amoxicillin/clavulanate, TMP/SMX, and ciprofloxacin decreased during the study period. E. coli percentages increased and those of Klebsiella spp. and Enterococcus spp. decreased with increase in patient age. Enterococcus. spp.-UTI was associated with older age and more severe findings on renal ultrasound. E. coli and Klebsiella spp. nonsusceptibility to amoxicillin/clavulanate, TMP/SMX, cefuroxime, and ceftriaxone was low.
AB - The objectives of the study were to describe the epidemiologic, microbiologic, and imaging characteristics of first 44 UTI episode in hospitalized infants and children < 2 years of age. A UTI episode was diagnosed based on suprapubic aspiration or urinary catheterization and report of a significant bacterial growth of true uropathogens. Two thousand two hundred ninety-four UTI episodes were recorded during 2009–2013 in 1694 patients; 1350 (79.7%), 223 (13.2%), and 66 (3.9%) had one, two, and three episodes, respectively. Of 1955 pathogens isolated, the most frequent were E. coli, Klebsiella spp., and Enterococcus spp. (56.9%, 14.1%, and 11%, respectively). E. coli percentages increased with increase in patient age while Klebsiella spp. and Enterococcus spp. decreased with decrease in age. 136/344 (39.5%) renal ultrasound examinations performed were reported abnormal. The percentages of abnormal ultrasound examinations in Enterococcus spp.-UTI were higher than in E. coli and Klebsiella spp.-UTI (P < 0.001 and P = 0.007, respectively). The E. coli nonsusceptibility to ampicillin, TMP/SMX, ceftriaxone, amoxicillin/clavulanic acid, cefuroxime, and gentamicin was 71%, 31%, 14.9%, 14.7%, 7%, and 4.4%, respectively. Nonsusceptibility of Klebsiella spp. to ampicillin, amoxicillin/clavulanic acid, TMP/SMX, ceftriaxone, gentamicin, and cefuroxime was 98.7%, 10.4%, 9.5%, 8.4%, 4.8%, and 4.3%, respectively. E. coli nonsusceptibility to amoxicillin/clavulanate, TMP/SMX, and ciprofloxacin decreased during the study period. E. coli percentages increased and those of Klebsiella spp. and Enterococcus spp. decreased with increase in patient age. Enterococcus. spp.-UTI was associated with older age and more severe findings on renal ultrasound. E. coli and Klebsiella spp. nonsusceptibility to amoxicillin/clavulanate, TMP/SMX, cefuroxime, and ceftriaxone was low.
KW - Antibiotics
KW - Escherichia coli
KW - Infants
KW - Ultrasound
KW - Urinary tract infection
UR - http://www.scopus.com/inward/record.url?scp=85077898943&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10096-019-03810-w
DO - https://doi.org/10.1007/s10096-019-03810-w
M3 - Article
C2 - 31930442
SN - 0934-9723
VL - 39
SP - 955
EP - 963
JO - European Journal of Clinical Microbiology and Infectious Diseases
JF - European Journal of Clinical Microbiology and Infectious Diseases
IS - 5
ER -