Urinary Tract Infections Caused by Community-Acquired Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in a Level III Hospital - A Retrospective Study

Authors

  • Ana Simões Serviço de Urgência e Unidade de Infeciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. https://orcid.org/0000-0001-8443-0689
  • Margarida Lima Faculdade de Medicina. Universidade de Coimbra. Coimbra.
  • Ana Brett Serviço de Urgência e Unidade de Infeciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Faculdade de Medicina. Universidade de Coimbra. Coimbra.
  • Carolina Queiroz Serviço de Patologia Clínica. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Catarina Chaves Serviço de Patologia Clínica. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Henrique Oliveira Serviço de Patologia Clínica. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Luís Januário Serviço de Urgência e Unidade de Infeciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Fernanda Rodrigues Serviço de Urgência e Unidade de Infeciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Faculdade de Medicina. Universidade de Coimbra. Coimbra.

DOI:

https://doi.org/10.20344/amp.12338

Keywords:

Anti-Bacterial Agents, beta-Lactamases, Child, Community-Acquired Infections, Enterobacteriaceae, Enterobacteriaceae Infections, Urinary Tract Infections

Abstract

Introduction: The emergence of β-lactamases producing bacteria is a problem worldwide, with increasing importance in communityacquired infections, especially in urinary tract infections. Data regarding the use of non-carbapenem antimicrobials in these infections are scarce. The aim of this study was to analyse the treatment and outcome of urinary tract infections caused by community-acquired β-lactamase-producing bacteria in children.
Material and Methods: Retrospective study performed in a level III paediatric hospital, between June 2007 and December 2017. All children with β-lactamase-producing Enterobacteriaceae identified in aseptically collected urine culture were included.
Results: A total of 175 urinary infections caused by β-lactamases producing bacteria were diagnosed, 34 (19%) were community-acquired: 25 Escherichia coli (74%), 4 Klebsiella pneumoniae (12%), 4 Proteus mirabilis (12%) and 1 Proteus vulgaris (3%). In 30 (88%) cases, it was the first urinary infection. After identification of the microorganism and antimicrobial susceptibility, 33 (97%) children were re-evaluated and 24 (71%) had a repeat urine culture, which was positive in three (13%). In six (18%) cases, antibiotic treatment was modified. Four (12%) children had another UTI in the following month. In 30 (88%) children, imaging was carried out, with no nephrourological malformations detected.
Discussion: In the last decade, about 20% of urinary infections caused by β-lactamase-producing Enterobacteriaceae were community-acquired with a relatively stable number of cases over the years. No nephro-urological malformations were identified in these children.
Conclusion: Although the number of cases is small, the clinical and microbiological outcomes showed that most were successfully treated with non-carbapenem antibiotics, with low recurrence of new episodes of urinary tract infections.

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Published

2020-07-01

How to Cite

1.
Simões A, Lima M, Brett A, Queiroz C, Chaves C, Oliveira H, Januário L, Rodrigues F. Urinary Tract Infections Caused by Community-Acquired Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in a Level III Hospital - A Retrospective Study. Acta Med Port [Internet]. 2020 Jul. 1 [cited 2023 Feb. 7];33(7-8):466-74. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12338