Clinical features and treatment strategies of febrile urinary tract infection caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae in children: a multicenter retrospective observational study in Japan

被引：0

作者：

Ohnishi, Takuma ^{[1
,2
]}

Mishima, Yoshinori ^{[1
]}

Naito, Tomomi ^{[3
]}

Matsuda, Nozomi ^{[4
]}

Ariji, Shohei ^{[5
]}

Umino, Daisuke ^{[6
]}

Tamura, Kikuko ^{[7
]}

Nishimoto, Hajime ^{[8
]}

Kinoshita, Keiji ^{[9
]}

Maeda, Naonori ^{[10
]}

Kawaguchi, Azusa ^{[11
]}

Yonezawa, Ryuta ^{[12
]}

Mimura, Shigenao ^{[13
]}

Fukushima, Hiroyuki ^{[14
]}

Nanao, Kenji ^{[15
]}

Yoshida, Makoto ^{[16
]}

Sekijima, Toshio ^{[17
]}

Kamimaki, Isamu ^{[1
]}

机构：

[1] Natl Hosp Org Saitama Hosp, Dept Pediat, 2-1 Suwa, Wako, Saitama 3510102, Japan

[2] Keio Univ, Dept Pediat, Sch Med, Tokyo, Japan

[3] Saiseikai Kawaguchi Gen Hosp, Dept Pediat, Saitama, Japan

[4] Soka Municipal Hosp, Dept Pediat, Saitama, Japan

[5] Kawaguchi Municipal Med Ctr, Dept Pediat, Saitama, Japan

[6] Tsuchiya Childrens Hosp, Saitama, Japan

[7] Natl Hosp Org Nishisaitama Chuo Natl Hosp, Dept Pediat, Saitama, Japan

[8] Saitama Citizens Med Ctr, Dept Pediat, Saitama, Japan

[9] Koshigaya Municipal Hosp, Dept Pediat, Saitama, Japan

[10] Natl Hosp Org Tokyo Med Ctr, Dept Pediat, Tokyo, Japan

[11] Natl Hosp Org Hokkaido Med Ctr, Dept Pediat Nephrol, Sapporo, Hokkaido, Japan

[12] IMS Fujimi Gen Hosp, Dept Pediat, Saitama, Japan

[13] Ageo Cent Gen Hosp, Dept Pediat, Saitama, Japan

[14] Ichikawa Gen Hosp, Dept Pediat, Tokyo Dent Coll, Chiba, Japan

[15] Hino Municipal Hosp, Dept Pediat, Tokyo, Japan

[16] Sano Kosei Gen Hosp, Dept Pediat, Sano, Tochigi, Japan

[17] Hanyu Gen Hosp, Dept Pediat, Saitama, Japan

来源：

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES | 2022年 / 125卷

关键词：

Urinary tract infection; Extended-spectrum; beta-lactamase-producing; Enterobacteriaceae; Cephalosporins; RISK-FACTORS; ESCHERICHIA-COLI; INFANTS;

D O I：

10.1016/j.ijid.2022.09.033

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: The incidence of infections caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria has increased. This study aimed to clarify the risk factors and treatment strategies for febrile urinary tract infection (fUTI) caused by ESBL-producing bacteria in Japanese children. Methods: A retrospective observational study was conducted in 21 hospitals among children aged <16 years diagnosed with an fUTI between 2008 and 2017. Clinical data of children with fUTI caused by ESBLproducing and non-ESBL-producing bacteria were compared. Results: Of the 2049 cases of fUTI, 147 (7.2%) were caused by ESBL-producing bacteria. Children in the ESBL group were more likely to have a history of recent antibiotic use or prophylactic antibiotic use, and experience recurrent UTIs (P <0.001) compared with those in the non-ESBL group. Of the 124 cases of fUTI due to ESBL-producing bacteria that were reviewed, 20 and 100 had concordant and discordant antibiotic use, respectively, and four had unknown antibiotic susceptibility. The median time from the start of treatment to fever resolution was 24 hours and did not differ significantly by therapy group (P = 0.39). Conclusion: ESBL-producing bacteria should be considered in children with recurrent UTIs and recent antibiotic use. Most children with fUTI experience clinical improvement regardless of the choice of antibiotic. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

引用

页码：97 / 102

页数：6

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