Browse > Article
http://dx.doi.org/10.3339/jkspn.2012.16.1.38

Clinical Significance of Extended-Spectrum ${\beta}$-Lactamase Producing $Escherichia$ $coli$ in Pediatric Patients with Febrile Urinary Tract Infection  

Park, Cheol (Department of Pediatrics, Korea University)
Kim, Min-Sang (Department of Pediatrics, Korea University)
Kim, Mi-Kyung (Department of Pediatrics, Korea University)
Yim, Hyung-Eun (Department of Pediatrics, Korea University)
Yoo, Kee-Hwan (Department of Pediatrics, Korea University)
Hong, Young-Sook (Department of Pediatrics, Korea University)
Lee, Joo-Won (Department of Pediatrics, Korea University)
Publication Information
Childhood Kidney Diseases / v.16, no.1, 2012 , pp. 38-45 More about this Journal
Abstract
Purpose: The incidence of community-acquired urinary tract infection (UTI) due to extended-spectrum ${\beta}$-lactamase producing $Escherichia$ $coli$ (ESBL(+) $E.$ $coli$) has increased worldwide. ESBL causes resistance to various types of the newer ${\beta}$-lactam antibiotics, including the expanded spectrum cephalosporins and monobactams. We aimed to investigate the severity of UTI and associated genitourinary malformations in children with febrile UTI caused by ESBL(+) $E.$ $coli$. Methods: We retrospectively reviewed the medical records of 290 patients diagnosed as febrile UTI caused by $E.$ $coli$ between January 2008 and October 2010 at Korea University Medical center. We classified the patients into two groups with ESBL(+) and ESBL(-) $E.$ $coli$ group according to the sensitivity of urine culture. Fever duration, admission period, white blood cell (WBC) counts and C-reactive protein (CRP) in peripheral blood, the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR) and renal scar were compared between the two groups. Results: Patients with ESBL(+) $E.$ $coli$ were 32, and those with ESBL(-) $E.$ $coli$ were 258. If we excluded those tested with a sterile urine bag, patients with ESBL(+) $E.$ $coli$ were 22, and those with ESBL(-) $E.$ $coli$ were 212. Whether the results of sterile urine bag tests were included or not, there was no significant difference in all parameters between the two groups statistically. Conclusion: Our data shows that ESBL(+) $E.$ $coli$ may not be related to the severity of UTI and associated genitourinary malformations.
Keywords
Extended-spectrum ${\beta}$-lactamase; Escherichia coli; Urinary tract infection;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Hirakata Y, Matsuda J, Miyazaki Y, Kamihira S, Kawakami S, Miyazawa Y, et al. Regional variation in the prevalence of extended-spectrum $\beta$-lactamase producing clinical isolates in the Asia-Pacific region (SENTRY 1998-2002). Diagn Microbiol Infect Dis 2005;52:323-9.   DOI   ScienceOn
2 Du Bois SK, Marriot MS, Amyes S.G.B. TEM- and SHV-derived extended-spectrum $\alpha$-lactamase: Relationship between selection, structure and function. J Antimicrob Chemother 1995;35:1697-704.
3 Knothe H, Shah P, Kremery V, Antal M, Mitsuhashi S. Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens. Infection 1983;11:315-7.   DOI   ScienceOn
4 Jacoby GA. Extended-spectrum beta-lactamases and other enzymes providing resistance to oxymino-beta-lactams. Infect Dis Clin North Am 1997;11:875-87.   DOI   ScienceOn
5 Paterson DL, Bonomo RA. Extended-spectrum betalactamases: a clinical update. Clin Microbiol Rev 2005;18:657-86   DOI   ScienceOn
6 Jarlier N, Nicolas M-H, Fournier G, Philippon A. Extended broad-spectrum $\beta$-lactamase conferring transferable resistance to newer $\beta$-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility pattern. Rev Infect Dis 1988;10:867-78.   DOI
7 Bush K, Jacoby GA, Medeiros AA. A functional classification scheme for beta-lactamase and its correlation with molecular structure. Antimicrob Agents Chemother 1995;39:211-33.
8 Cantón R, Novais A, Valverde A, Machado E, Peixe L, Baquero F, et al. Prevalence and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae in Europe. Clin Microbiol Infect 2008;1:144-53.
9 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.   DOI   ScienceOn
10 American academy of pediatrics, committee on quality improvement, subcommittee on urinary tract infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics 1999;103:843-51.
11 Jacobson SH, Eklof O, Eriksson CG, Lins LE, Tidgren B, Winberg J. Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up. BMJ 1989; 299:703-6.   DOI   ScienceOn
12 Prajapati BS, Prajapati RB, Patel PS. Advances in management of urinary tract infections. Indian J Pediatr 2008;75:809-14.   DOI   ScienceOn
13 Lee SY, Lee JH, Kim JH, Hur JK, Kim SM, Ma SH, et al. Susceptibility tests of oral antibiotics including cefixime against Escherichia coli, isolated from pediatric patients with community acquired urinary tract infections. Korean J Pediatr 2006;49:777-83.   DOI
14 Oteo J, Perez-Vazquez M, Campos J. Extended-spectrum b-lactamase-producing Escherichia coli : changing epidemiology and clinical impact. Curr Opin Infect Dis 2010;23:320-6.   DOI
15 Yiee J, Wilcox D. Management of fetal hydronephrosis. Pediatr Nephrol 2008;23:347-53.   DOI   ScienceOn
16 Jaksic E, Bogdanovic R, Artiko V, Saranovic DS, Petrasinovic Z, Petrovic M, et.al. Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis. Ann Nucl Med 2011;25:37-43.   DOI   ScienceOn
17 Piepsz A, Gordon I, Hahn K. Paediatric nuclear medicine. Eur J Nucl Med 1991;18:41-66.
18 Williams G, Craig JC. Prevention of recurrent urinary tract infection in children. Curr Opin Infect Dis 2009;22:72-6.   DOI   ScienceOn
19 Lavocat MP, Granjon D, Guimpied Y, Dutour N, Allard D, Prevot N, et al. The importance of 99mTc-DMSA renal scintigraphy in the follow-up of acute pyelonephritis in children: comparison with urographic data. Nucl Med Commun 1998;19:703-10.   DOI   ScienceOn
20 Ferraro MJ, Craig WA, Dudley MN. Performance standards for antimicrobial susceptibility testing. An NCCLS global informational supplement. 12th. 2002;22:37-46.
21 Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood. Pediatr Infect Dis J 2008;27:302-8.   DOI   ScienceOn
22 Noemia PG, Angelica M. Febrile urinary tract infection: Escherichia coli susceptibility to oral antimicrobials. Pediatr Nephrol 2002;17:173-6.   DOI   ScienceOn
23 American academy of pediatrics, steering committee on quality improvement and management, subcommittee on urinary tract infection. Urinary tract infection : Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 2011;128:595-610.   DOI   ScienceOn
24 Smith T, Evans K, Lythgoe MF, Anderson PJ, Gordon I . Radiation dosimetry of technetium-99m-DMSA in children. J Nucl Med 1996;37:1336-42.
25 Paquin AJ. Ureterovesical anastamosis: the description and evaluation of a technique. J Urol 1959;82:573-83.
26 Chand DH, Rhoades T, Poe SA, et al. Incidence and severity of vesicoureteral reflux in children related to age, gender, race and diagnosis. J Urol 2003;170:1548-50.   DOI   ScienceOn
27 Brigante G, Luzzaro F, Perilli M, Lombardi G, Coli A, Rossolini GM, et al. Evolution of CTX-M-type beta-lactamases in isolates of Escherichia coli infecting hospital and community patients. Int J Antimicrob Agents 2005;25:157-62.   DOI   ScienceOn
28 Rushton HG. The evaluation of acute pyelonephritis and renal scarring with technetium 99m-dimercaptosuccinic acid renal scintigraphy: evolving concepts and future directions. Pediatr Nephrol 1997;11:108-20.   DOI   ScienceOn
29 Brun-Buisson C, Legrand P, Phillippon A, Montravers F, Ansquer M, Duval J. Transferable enzymatic resistance to third-generation cephalosporins during nosocomial outbreak of multiresistant Klebsiella pneumoniae. Lancet 1987;2:302-6.
30 Lohr JA, Portilla MG, Geuder TG, Dunn ML, Dudley SM. Making a presumptive diagnosis of urinary tract infection by using a urinalysis performed in an on-site. Laboratory J Pediatr 1993;122:22-5.   DOI
31 Pai H. The characteristics of extended-spectrum beta-lactamases in Korean isolates of Enterobacteriaceae. Yonsei Med J 1998;39:514-9.
32 Lee JW, Shin JS, Seo JW, Lee MA, Lee SJ. Incidence and risk factors for extended-spectrum betalactamase-producing Escherichia coli in community-acquired childhood urinary tract infection. J Korean Soc Pediatr Nephrol 2004;8:214-22.
33 Topaloglu R, Er I, Dogan BG, Bilginer Y, Ozaltin F, Besbas N, et al. Risk factors in community-acquired urinary tract infections caused by ESBL-producing bacteria in children. Pediatr Nephrol 2010;25:919-25.   DOI   ScienceOn
34 Kim NH, Lee JA, Kim YK, Choi EH, Ha IS, Lee HJ, Choi Y. Risk factors of urinary tract infections due to extended-spectrum beta-lactamase producing Escherichia coli in children. Korean J Pediatr 2004;47:164-9.
35 Mo EH, Nam IH, Park KD. Protein C as a differential marker for bacterial infection among pediatric patients with fever. Korean J Pediatr 2004;47:839-43.
36 Jung JI, Lim DH, Yim HE, Park MS, Yoo KH, Hong YS, et al. Fever duration and renal scar in pediatric urinary tract infection. J Korean Soc Pediatr Nephrol 2008;12:70-7.   DOI
37 Hellstrom A, Hanson E, Hansson S, Hjalmas K, Jodal U. Association between urinary symptoms at 7 years old and previous urinary tract infection. Arch Dis Child 1991;66:232-4.   DOI   ScienceOn
38 Marild S, Jodal U. Incidence rate of first-time symptomatic urinary tract infection in children under 6 years of age. Acta Paediatr 1998;87:549-52.   DOI   ScienceOn