Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factors
Purpose To identify the differences in features between children with urinary tract infection (UTI) caused by extended-spectrum beta-lactamases (ESBL)-positive and -negative Escherichia coli, and analyze risk factors for the former infection. Methods We reviewed medical records of children younger t...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Pediatric Emergency Medicine
2020-12-01
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| Series: | Pediatric Emergency Medicine Journal |
| Subjects: | |
| Online Access: | http://pemj.org/upload/pdf/pemj-2020-00045.pdf |
| _version_ | 1797852273163894784 |
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| author | Sang-hwa Hong Hyo-bin Kim Hee Won Chueh |
| author_facet | Sang-hwa Hong Hyo-bin Kim Hee Won Chueh |
| author_sort | Sang-hwa Hong |
| collection | DOAJ |
| description | Purpose To identify the differences in features between children with urinary tract infection (UTI) caused by extended-spectrum beta-lactamases (ESBL)-positive and -negative Escherichia coli, and analyze risk factors for the former infection. Methods We reviewed medical records of children younger than 36 months with E. coli UTI who visited the emergency department from January 2012 through January 2019. Differences in variables regarding clinical, laboratory, and microbiologic (i.e., ESBL-positive E. coli on urine culture) features, and outcomes between the ESBL-positive and -negative groups were identified. Factors associated with ESBL-positive E. coli infection were analyzed by logistic regression. Results The children were classified into the ESBL-positive (n = 151) and -negative (n = 40) groups. The former group showed higher frequency of prior UTI (P = 0.038) without other differences between the groups. The median counts of white blood cells, absolute neutrophils, and absolute lymphocytes were higher in the ESBL-positive group than in the other group (P = 0.009, 0.022, and 0.027, respectively). The former group showed longer median hospital length of stay (11.0 days [interquartile range, 8.9-12.0] vs. 6.0 [5.0-7.0]; P < 0.001), and more frequent recurrence per child (3.0 [2.5-3.0] vs. 1.0 [1.0-1.8]; P = 0.047) and presence of vesicoureteral reflux (27.5% vs. 13.2%; P = 0.001). Logistic regression showed leukocytosis (odds ratio, 12.85; 95% confidence interval, 1.04-157.69) and vesicoureteral reflux (4.00; 1.19-13.43) as the factors for ESBL-positive E. coli infection. Conclusion The ESBL-positive group showed significantly higher leukocyte count and rate of vesicoureteral reflux than the ESBL-negative group. For children with these features, empirical antibiotics should be chosen in consideration of the resistant bacteria. |
| first_indexed | 2024-04-09T19:31:23Z |
| format | Article |
| id | doaj.art-cbc5c3d011de4bb5ad0a2ca381a54c53 |
| institution | Directory Open Access Journal |
| issn | 2383-4897 2508-5506 |
| language | English |
| last_indexed | 2024-04-09T19:31:23Z |
| publishDate | 2020-12-01 |
| publisher | Korean Society of Pediatric Emergency Medicine |
| record_format | Article |
| series | Pediatric Emergency Medicine Journal |
| spelling | doaj.art-cbc5c3d011de4bb5ad0a2ca381a54c532023-04-04T23:54:31ZengKorean Society of Pediatric Emergency MedicinePediatric Emergency Medicine Journal2383-48972508-55062020-12-017210110710.22470/pemj.2020.00045108Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factorsSang-hwa Hong0Hyo-bin Kim1Hee Won Chueh2Department of Pediatrics, Dong-A University College of Medicine, 26 Daesingongwon-ro, Seo-gu, Busan 49201, KoreaDepartment of Pediatrics, Dong-A University College of Medicine, 26 Daesingongwon-ro, Seo-gu, Busan 49201, KoreaDepartment of Pediatrics, Dong-A University College of Medicine, 26 Daesingongwon-ro, Seo-gu, Busan 49201, KoreaPurpose To identify the differences in features between children with urinary tract infection (UTI) caused by extended-spectrum beta-lactamases (ESBL)-positive and -negative Escherichia coli, and analyze risk factors for the former infection. Methods We reviewed medical records of children younger than 36 months with E. coli UTI who visited the emergency department from January 2012 through January 2019. Differences in variables regarding clinical, laboratory, and microbiologic (i.e., ESBL-positive E. coli on urine culture) features, and outcomes between the ESBL-positive and -negative groups were identified. Factors associated with ESBL-positive E. coli infection were analyzed by logistic regression. Results The children were classified into the ESBL-positive (n = 151) and -negative (n = 40) groups. The former group showed higher frequency of prior UTI (P = 0.038) without other differences between the groups. The median counts of white blood cells, absolute neutrophils, and absolute lymphocytes were higher in the ESBL-positive group than in the other group (P = 0.009, 0.022, and 0.027, respectively). The former group showed longer median hospital length of stay (11.0 days [interquartile range, 8.9-12.0] vs. 6.0 [5.0-7.0]; P < 0.001), and more frequent recurrence per child (3.0 [2.5-3.0] vs. 1.0 [1.0-1.8]; P = 0.047) and presence of vesicoureteral reflux (27.5% vs. 13.2%; P = 0.001). Logistic regression showed leukocytosis (odds ratio, 12.85; 95% confidence interval, 1.04-157.69) and vesicoureteral reflux (4.00; 1.19-13.43) as the factors for ESBL-positive E. coli infection. Conclusion The ESBL-positive group showed significantly higher leukocyte count and rate of vesicoureteral reflux than the ESBL-negative group. For children with these features, empirical antibiotics should be chosen in consideration of the resistant bacteria.http://pemj.org/upload/pdf/pemj-2020-00045.pdfbacteriachilddrug resistanceemergency medicineescherichia colifeverurinary tract infections |
| spellingShingle | Sang-hwa Hong Hyo-bin Kim Hee Won Chueh Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factors Pediatric Emergency Medicine Journal bacteria child drug resistance emergency medicine escherichia coli fever urinary tract infections |
| title | Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factors |
| title_full | Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factors |
| title_fullStr | Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factors |
| title_full_unstemmed | Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factors |
| title_short | Clinical characteristics of children who visited the emergency department with extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection and its risk factors |
| title_sort | clinical characteristics of children who visited the emergency department with extended spectrum beta lactamase producing escherichia coli urinary tract infection and its risk factors |
| topic | bacteria child drug resistance emergency medicine escherichia coli fever urinary tract infections |
| url | http://pemj.org/upload/pdf/pemj-2020-00045.pdf |
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