Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy
The development and spread of antibiotic resistance is an increasingly important global public health problem, even in paediatric urinary tract infection (UTI). In light of the variability in the data, it is necessary to conduct surveillance studies to determine the prevalence of antibiotic resistan...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/10/1207 |
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| author | Susanna Esposito Giuseppe Maglietta Margherita Di Costanzo Martina Ceccoli Gianluca Vergine Claudio La Scola Cristina Malaventura Alice Falcioni Alessandra Iacono Antonella Crisafi Lorenzo Iughetti Maria Luisa Conte Luca Pierantoni Claudia Gatti Caterina Caminiti Giacomo Biasucci on behalf of the UTI-Ped-ER Study Group |
| author_facet | Susanna Esposito Giuseppe Maglietta Margherita Di Costanzo Martina Ceccoli Gianluca Vergine Claudio La Scola Cristina Malaventura Alice Falcioni Alessandra Iacono Antonella Crisafi Lorenzo Iughetti Maria Luisa Conte Luca Pierantoni Claudia Gatti Caterina Caminiti Giacomo Biasucci on behalf of the UTI-Ped-ER Study Group |
| author_sort | Susanna Esposito |
| collection | DOAJ |
| description | The development and spread of antibiotic resistance is an increasingly important global public health problem, even in paediatric urinary tract infection (UTI). In light of the variability in the data, it is necessary to conduct surveillance studies to determine the prevalence of antibiotic resistance in specific geographical areas to optimize therapeutic management. In this observational, retrospective, multicentre study, the medical records of 1801 paediatric patients who were hospitalised for UTI between 1 January 2012, and 30 June 2020, in Emilia-Romagna, Italy, were analysed. <i>Escherichia coli</i> was the most frequently detected pathogen (75.6%), followed by <i>Klebsiella pneumoniae</i> (6.9%) and <i>Pseudomonas aeruginosa</i> (2.5%). Overall, 840 cases (46.7%) were due to antimicrobial-resistant uropathogens: 83 (4.7%) extended spectrum beta-lactamase (ESBL)-producing, 119 (6.7%) multidrug resistant (MDR) and 4 (0.2%) extensively drug resistant (XDR) bacteria. Empirical antibiotic therapy failed in 172 cases (9.6%). Having ESBL or MDR/XDR uropathogens, a history of recurrent UTI, antibiotic therapy in the preceding 30 days, and empirical treatment with amoxicillin or amoxicillin/clavulanate were significantly associated with treatment failure, whereas first-line therapy with third-generation cephalosporins was associated with protection against negative outcomes. In conclusion, the increase in the resistance of uropathogens to commonly used antibiotics requires continuous monitoring, and recommendations for antibiotic choice need updating. In our epidemiological context, amoxicillin/clavulanate no longer seems to be the appropriate first-line therapy for children hospitalised for UTI, whereas third-generation cephalosporins continue to be useful. To further limit the emergence of resistance, every effort to reduce and rationalise antibiotic consumption must be implemented. |
| first_indexed | 2024-03-10T06:45:54Z |
| format | Article |
| id | doaj.art-050e9c9ef81c4450a3269ef8977036d4 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T06:45:54Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-050e9c9ef81c4450a3269ef8977036d42023-11-22T17:13:44ZengMDPI AGAntibiotics2079-63822021-10-011010120710.3390/antibiotics10101207Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, ItalySusanna Esposito0Giuseppe Maglietta1Margherita Di Costanzo2Martina Ceccoli3Gianluca Vergine4Claudio La Scola5Cristina Malaventura6Alice Falcioni7Alessandra Iacono8Antonella Crisafi9Lorenzo Iughetti10Maria Luisa Conte11Luca Pierantoni12Claudia Gatti13Caterina Caminiti14Giacomo Biasucci15on behalf of the UTI-Ped-ER Study GroupPediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyResearch and Innovation Unit, University Hospital, 43126 Parma, ItalyPaediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29122 Piacenza, ItalyPaediatrics Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, ItalyPaediatrics Unit, Rimini Hospital, AUSL Romagna, 47921 Rimini, ItalyPaediatric Clinic, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyPaediatric Clinic, University of Ferrara, 44124 Ferrara, ItalyPaediatric Unit, Forlì Hospital, AUSL Romagna, 47121 Forlì, ItalyPaediatrics and Neonatology Unit, Ravenna Hospital, AUSL Romagna, 48121 Ravenna, ItalyPaediatrics Unit, Santa Maria Nuova Hospital, AUSL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, ItalyPaediatrics Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, ItalyPaediatrics Unit, Rimini Hospital, AUSL Romagna, 47921 Rimini, ItalyPaediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyPaediatric Surgery, University Hospital, 43126 Parma, ItalyResearch and Innovation Unit, University Hospital, 43126 Parma, ItalyPaediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29122 Piacenza, ItalyThe development and spread of antibiotic resistance is an increasingly important global public health problem, even in paediatric urinary tract infection (UTI). In light of the variability in the data, it is necessary to conduct surveillance studies to determine the prevalence of antibiotic resistance in specific geographical areas to optimize therapeutic management. In this observational, retrospective, multicentre study, the medical records of 1801 paediatric patients who were hospitalised for UTI between 1 January 2012, and 30 June 2020, in Emilia-Romagna, Italy, were analysed. <i>Escherichia coli</i> was the most frequently detected pathogen (75.6%), followed by <i>Klebsiella pneumoniae</i> (6.9%) and <i>Pseudomonas aeruginosa</i> (2.5%). Overall, 840 cases (46.7%) were due to antimicrobial-resistant uropathogens: 83 (4.7%) extended spectrum beta-lactamase (ESBL)-producing, 119 (6.7%) multidrug resistant (MDR) and 4 (0.2%) extensively drug resistant (XDR) bacteria. Empirical antibiotic therapy failed in 172 cases (9.6%). Having ESBL or MDR/XDR uropathogens, a history of recurrent UTI, antibiotic therapy in the preceding 30 days, and empirical treatment with amoxicillin or amoxicillin/clavulanate were significantly associated with treatment failure, whereas first-line therapy with third-generation cephalosporins was associated with protection against negative outcomes. In conclusion, the increase in the resistance of uropathogens to commonly used antibiotics requires continuous monitoring, and recommendations for antibiotic choice need updating. In our epidemiological context, amoxicillin/clavulanate no longer seems to be the appropriate first-line therapy for children hospitalised for UTI, whereas third-generation cephalosporins continue to be useful. To further limit the emergence of resistance, every effort to reduce and rationalise antibiotic consumption must be implemented.https://www.mdpi.com/2079-6382/10/10/1207antibiotic therapyantimicrobial resistanceextended-spectrum beta-lactamase-producing bacteriaextensively drug-resistant bacteriamultidrug resistanceurinary tract infection |
| spellingShingle | Susanna Esposito Giuseppe Maglietta Margherita Di Costanzo Martina Ceccoli Gianluca Vergine Claudio La Scola Cristina Malaventura Alice Falcioni Alessandra Iacono Antonella Crisafi Lorenzo Iughetti Maria Luisa Conte Luca Pierantoni Claudia Gatti Caterina Caminiti Giacomo Biasucci on behalf of the UTI-Ped-ER Study Group Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy Antibiotics antibiotic therapy antimicrobial resistance extended-spectrum beta-lactamase-producing bacteria extensively drug-resistant bacteria multidrug resistance urinary tract infection |
| title | Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy |
| title_full | Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy |
| title_fullStr | Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy |
| title_full_unstemmed | Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy |
| title_short | Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy |
| title_sort | retrospective 8 year study on the antibiotic resistance of uropathogens in children hospitalised for urinary tract infection in the emilia romagna region italy |
| topic | antibiotic therapy antimicrobial resistance extended-spectrum beta-lactamase-producing bacteria extensively drug-resistant bacteria multidrug resistance urinary tract infection |
| url | https://www.mdpi.com/2079-6382/10/10/1207 |
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