Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
권호 표지
DOI QR코드

DOI QR Code

An Epidemiologic Study on Hosts and Pathogens of Urinary Tract Infection in Urban Children of Korea (2012-2017)

  • Yoo, Yeong Myong (Department of Pediatrics, Ajou University School of Medicine) ;
  • Park, Byeong Sub (Department of Pediatrics, Ajou University School of Medicine) ;
  • Lee, Shin Young (Department of Pediatrics, Ajou University School of Medicine) ;
  • Park, Kyu Jung (Department of Pediatrics, Ajou University School of Medicine) ;
  • Jung, Hyun Joo (Department of Pediatrics, Ajou University School of Medicine) ;
  • Pai, Ki Soo (Department of Pediatrics, Ajou University School of Medicine)
  • Received : 2018.09.21
  • Accepted : 2018.10.18
  • Published : 2019.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: We aimed to determine characteristics of host, causative organisms, and antibiotic susceptibility of bacteria in pediatric patients with UTI living in metropolitan area of Korea. Methods: Retrospective investigation was done for the causative organisms of UTI in 683 pediatric cases treated at Ajou University Hospital from 2012 to 2017. Patients were classified into Escherichia coli and non-E. coli group, where E. coli group was subdivided into ESBL(+) and ESBL(-) groups based on whether the bacteria could produce extended spectrum beta-lactamase (ESBL). Antibiotic susceptibility of the causative organism was also determined. Results: A total of 683 UTIs occurred in 550 patients, of which 463 (67.8%) were first-time infection and 87 (32.2%) were recurrent ones (2-7 recurrences, 2.52 average), and 64.9% were male and 35.1% were female. The most common causative organism was E. coli (77.2%) and ESBL(+) E. coli was found in 126 cases. The susceptibility of E. coli to 3rd or 4th generation cephalosporin was relatively higher than that to ampicillin or amoxicillin/clavulanic acid. ESBL(+) E. coli showed higher resistance rate to 3rd or 4th generation cephalosporin than ESBL(-) E. coli. Conclusion: New treatment guideline should be considered due to the incidence of ESBL(+) E. coli increased up to one quarter of UTI cases.

Keywords

References

  1. JS E. Nelson Textbook of Pediatrics. 18th ed. Urologic disorders in infants and children. Philadelphia: WB Saunders Co., 2007;2223-8.
  2. Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J 2008;27:302-8. https://doi.org/10.1097/INF.0b013e31815e4122
  3. Hoberman A, Charron M, Hickey RW, Baskin M, Kearney DH, Wald ER. Imaging studies after a first febrile urinary tract infection in young children. N Engl J Med 2003;348:195-202. https://doi.org/10.1056/NEJMoa021698
  4. Hoberman A W.E. Treatment of urinary tract infections. Pediatr Infect Dis J 1999;18:1020-1. https://doi.org/10.1097/00006454-199911000-00018
  5. Engel JD, Schaeffer AJ. Evaluation of and antimicrobial therapy for recurrent urinary tract infections in women. Urol Clin North Am 1998;25:685-701. https://doi.org/10.1016/S0094-0143(05)70057-4
  6. Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA). Clin Infect Dis 1999;29:745-58. https://doi.org/10.1086/520427
  7. Cheng CH, Tsau YK, Lin TY. Effective duration of antimicrobial therapy for the treatment of acute lobar nephronia. Pediatrics 2006;117:84-9. https://doi.org/10.1542/peds.2004-2292
  8. Kass EH. Asymptomatic infections of the urinary tract. 1956. J Urol 2002;167:1016-9. https://doi.org/10.1016/S0022-5347(02)80328-7
  9. Rubin RH, Shapiro ED, Davis RJ, Stamm WE. Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Infectious Diseases Society of America and the Food and Drug Administration. Clin Infect Dis 1992;15:216-27. https://doi.org/10.1093/clind/15.Supplement_1.S216
  10. Ryu KH, Kim MK, Jeong YB. A Recent Study on the Antimicrobial Sensitivity of the Organisms that Cause Urinary Tract Infection. Korean J Urol 2007;48:603-645. https://doi.org/10.4111/kju.2007.48.6.603
  11. Bahna SL, Torp KH. The sex variable in childhood urinary-tract infection. Acta Paediatr Scand 1975;64:581-6. https://doi.org/10.1111/j.1651-2227.1975.tb03886.x
  12. Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am 1997;11:551-81. https://doi.org/10.1016/S0891-5520(05)70373-1
  13. LE N. Epidemiology of urinary infection. Infect Med 2001;18:153-62.
  14. Stamm WE, Norrby SR. Urinary tract infections: disease panorama and challenges. J Infect Dis 2001;183:S1-4. https://doi.org/10.1086/317653
  15. Ashkenazi S, Even-tov S, Samra Z, Dinari G. Uropathogens of various childhood populations and their antibiotic susceptibility. Pediatr Infect Dis J 1991;10:742-6. https://doi.org/10.1097/00006454-199110000-00005
  16. Hellerstein S. Urinary tract infections. Old and new concepts. Pediatr Clin North Am 1995;42:1433-57. https://doi.org/10.1016/S0031-3955(16)40092-1
  17. Hoberman A, Wald ER, Hickey RW, Baskin M, Charron M, Majd M, et al. Oral versus initial intravenous therapy for urinary tract infections in young febrile children. Pediatrics 1999;104:79-86. https://doi.org/10.1542/peds.104.1.79
  18. Jung HJ, Aum JA, Jung SJ, Huh JW. Different characteristic between Escherichea coli and non-Escherichea coli urinary tract infection. Korean J Pediatr 2007;50:457-61. https://doi.org/10.3345/kjp.2007.50.5.457

Cited by

  1. Current status of long-term antibiotic prophylaxis for urinary tract infections in children: An antibiotic stewardship challenge vol.38, pp.4, 2019, https://doi.org/10.23876/j.krcp.19.091
  2. Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factors vol.7, pp.2, 2020, https://doi.org/10.22470/pemj.2020.00045
  3. Impact of early-life weight status on urinary tract infections in children: a nationwide population-based study in Korea vol.43, 2019, https://doi.org/10.4178/epih.e2021005
  4. Maternal antibiotic exposure during pregnancy is a risk factor for community-acquired urinary tract infection caused by extended-spectrum beta-lactamase-producing bacteria in infants vol.37, pp.1, 2019, https://doi.org/10.1007/s00467-021-05163-z