Increasing Prevalence of Pediatric Community-acquired UTI by Extended Spectrum β-Lactamase-producing E. coli: Cause for Concern

Pediatr Infect Dis J. 2023 Feb 1;42(2):106-109. doi: 10.1097/INF.0000000000003777. Epub 2022 Nov 15.

Abstract

Background: Antimicrobial resistance and emerging spectrum-β-lactamase (ESBL) infections are a rising concern in public health. Despite the increasing prevalence of community-acquired (CA) ESBL-E. coli UTIs, there is little data on the antibiotic resistance profiles of this bacterial strain in the pediatric population. We review antibiotic resistance profile and rising trend in pediatric ESBL-E. coli UTI presentation at our pediatric hospital.

Methods: This retrospective study reviewed data drawn from the infectious disease database at our pediatric hospital for all patients whose urine culture grew ESBL-E. coli from 01/2015 to 01/2021. Demographic information and antimicrobial susceptibility test results for ESBL-E. coli isolates from CA-UTIs were collected. Annual changes in resistance to antimicrobial agents and average annual percent change in ESBL-E. coli UTI presentation over the study period are reported.

Results: From 01/2015 to 01/2021, 6403 urine cultures at our hospital grew E. coli. Of these, 169 urine cultures from 135 children grew ESBL-E. coli. The study population was 57% male (77) with a mean age of 6.9 ± 6.2 years and multiethnic. CA-UTI by ESBL-producing E. coli accounted for 2.62% of total E. coli UTIs within the study period and increased from 0.97% in 2015 to 3.54% in 2020 by an average of 0.51% each year.

Conclusions: These findings demonstrate an increase in CA-ESBL E. coli UTIs in children. We observed most isolates demonstrated multidrug resistance. As CA-ESBL E. coli UTIs are associated with prolonged hospitalization and increased morbidity, our findings highlight the rising trend in pediatric CA-ESBL E. coli UTI.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents*
  • Child
  • Child, Preschool
  • Community-Acquired Infections* / microbiology
  • Escherichia coli
  • Escherichia coli Infections* / drug therapy
  • Escherichia coli Infections* / epidemiology
  • Female
  • Humans
  • Infant
  • Male
  • Prevalence
  • Retrospective Studies
  • Urinary Tract Infections* / microbiology
  • beta-Lactamases

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases
  • Anti-Infective Agents