The Characteristics of Children with UTI Due to ESBL-producing Bacteria at Dr. Soetomo General Hospital, Surabaya

Ida Fitriawati, M. Wahyunitisari, R. Prasetyo, Dwiyanti Puspitasari
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Abstract

Introduction: Urinary tract infection (UTI) by extended-spectrum beta-lactamase-producing bacteria often results in a delay in obtaining appropriate antibiotics. The information on patients’ clinical characteristics is necessary for early recognition and the selection of empiric antibiotic therapy. This study aims to investigate the clinical characteristics and the length of therapy of patients with urinary tract infections by those resistant bacteria.Method: This study utilizes a cross-sectional design. Medical records of hospitalized children aged 1-18 months with UTI due to ESBL-producing bacteria at Dr. Soetomo general hospital between January 1, 2017 - July 20, 2020, were reviewed retrospectively. Variables of interest were the demographic data, underlying diseases, causative organism, clinical presentation, maximal body temperature, and length of antibiotic therapy.Results: Among 37 patients enrolled, 25 patients were female. The incidence of urinary tract infection in children was dominated by age 1-12 months old (37.8%). Urological abnormalities were presented in 62.2% of patients. ESBL-producing Escherichia coli was the most common isolated uropathogen (62.2%). High fever was found in 10/28 patients (35.7%). In 17 patients (45.9%), the total duration of antibiotic therapy was 8-14 days.Conclusion: In children with UTI, especially in the infant group, who had urological abnormality or present with a high fever, and who do not respond to empiric therapy should be suspected of developing UTI due to ESBL-producing bacteria.
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泗水Dr. Soetomo总医院产esbl细菌所致尿路感染儿童的特点
由广谱β -内酰胺酶产生的细菌引起的尿路感染(UTI)经常导致获得适当抗生素的延迟。了解患者的临床特征对早期识别和选择经验性抗生素治疗是必要的。本研究旨在探讨耐药菌尿路感染患者的临床特点及治疗时间。方法:本研究采用横断面设计。回顾性分析2017年1月1日至2020年7月20日在Dr. Soetomo综合医院因产esbl细菌引起的1-18月龄尿路感染住院患儿的病历。感兴趣的变量包括人口统计数据、潜在疾病、致病生物、临床表现、最高体温和抗生素治疗时间。结果:37例入组患者中,女性25例。儿童尿路感染发生率以1 ~ 12月龄为主(37.8%)。62.2%的患者出现泌尿系统异常。产esbl的大肠杆菌是最常见的尿路病原菌(62.2%)。10/28例患者出现高热(35.7%)。17例(45.9%)患者抗生素治疗总持续时间为8 ~ 14天。结论:对于尿路感染的儿童,特别是婴儿组,如果出现泌尿系统异常或出现高烧,并且经验性治疗无效,应怀疑由于产生esbl的细菌而发生尿路感染。
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