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Pathogens Causing Pediatric Community Acquired Urinary Tract Infections and Their Increasing Antimicrobial Resistance: A Nationwide Study.
Shkalim Zemer, Vered; Ashkenazi, Shai; Levinsky, Yoel; Richenberg, Yael; Jacobson, Eyal; Nathanson, Shay; Shochat, Tzippy; Kushnir, Shiri; Cohen, Moriya; Cohen, Avner Herman.
Afiliação
  • Shkalim Zemer V; Clalit Health Services, Petach Tikva 4900000, Israel.
  • Ashkenazi S; Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
  • Levinsky Y; Adelson School of Medicine, Ariel University, Ariel 4070000, Israel.
  • Richenberg Y; Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
  • Jacobson E; Pediatric Rheumatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 4920235, Israel.
  • Nathanson S; Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
  • Shochat T; Dan-Petach Tikva District, Clalit Health Services, Petach Tikva 4972339, Israel.
  • Kushnir S; Dan-Petach Tikva District, Clalit Health Services, Petach Tikva 4972339, Israel.
  • Cohen M; Dan-Petach Tikva District, Clalit Health Services, Petach Tikva 4972339, Israel.
  • Cohen AH; Statistical Consultation Unit, Rabin Medical Center, Beilinson Hospital, Petach Tikva 4941492, Israel.
Pathogens ; 13(3)2024 Feb 24.
Article em En | MEDLINE | ID: mdl-38535544
ABSTRACT
Urinary tract infections (UTIs) in childhood are common and are associated with considerable acute morbidity and long-term complications. The need for updated data to optimize empiric antibiotic therapy is crucial. We aimed to investigate the pathogens causing pediatric community acquired UTIs, their correlation with demographic characteristics, and trends in their antimicrobial resistance. This nationwide cross-sectional study included all 53,203 children (<18 years) diagnosed with UTI in community outpatient clinics in the following selected years 2007, 2011, 2015, 2019 and 2021. Escherichia coli (E. coli) (82.1%) was the most common uropathogen, followed by Enterobacter, Klebsiella, Proteus, Pseudomonas, and Enterococcus species. The bacterial distribution displayed statistically significant (p < 0.0001) gender- and sector-specific patterns with a higher relative prevalence of non-E. coli UTI in Jewish and males. The rate of extended-spectrum beta-lactamase-positive E. coli increased substantially and significantly (p < 0.001) from only 6.1% in 2007 to 25.4% in 2021. Most non-E. coli uropathogens exhibited resistance to commonly used empiric antibiotics for UTIs in children. These findings are significant in guiding optimal empiric antibiotic treatment for pediatric community acquired UTIs. The resistance of uropathogens to antimicrobials is region- and time-dependent. Therefore, the periodic and local assessment of antibiotic resistance trends is essential to update guidelines and provide the most appropriate antibacterial therapy for children with UTIs.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Pathogens Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Pathogens Ano de publicação: 2024 Tipo de documento: Article