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Observational Study
. 2023 Feb 11;101(2):285-291.

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

Abir Boussetta  1 , Nouha Kharbach  1 , Abir Abdellatif  1 , Amina Karray  2 , Manel Jellouli  1 , Tahar Gargah  1
Affiliations
Observational Study

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

Abir Boussetta et al. Tunis Med. .

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.

Conclusion: 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.

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Figures

None
UTI episodes among patients aged between 0 and 20 years old, treated at the Pediatrics department of the Charles Nicolle Hospital in Tunis between January 1st 2019 and December,31, 2020 n=370
See this image and copyright information in PMC

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