Pathogens causing urinary tract infections in infants: a European overview by the ESCAPE study group

ALBERICI I., Bayazit A. K., DROZDZ D., Emre S., FISCHBACH M., HARAMBAT J., ...More

EUROPEAN JOURNAL OF PEDIATRICS, vol.174, no.6, pp.783-790, 2015 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 174 Issue: 6
  • Publication Date: 2015
  • Doi Number: 10.1007/s00431-014-2459-3
  • Journal Name: EUROPEAN JOURNAL OF PEDIATRICS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.783-790
  • Keywords: Urinary tract infection, Antibiotic resistance, Infants, Escherichia coli, Urine culture, ANTIBIOTIC-RESISTANCE, ANTIMICROBIAL RESISTANCE, ESCHERICHIA-COLI, VESICOURETERAL REFLUX, TURKISH CHILDREN, YOUNG-CHILDREN, SUSCEPTIBILITY, UROPATHOGENS, PREVALENCE, PATTERNS
  • Çukurova University Affiliated: Yes

Abstract

Knowledge of the distribution spectrum of causative organisms and their resistance patterns has become a core requirement for the rational and effective management of urinary tract infections. In the context of a prospective trial on the use of antibiotic prophylaxis in infants with underling kidney malformations, we conducted an online survey among paediatric nephrologists on positive urine cultures (July 2010-June 2012) from both hospitalized and non-hospitalized infants under 24 months of age. We collected 4745 urine cultures (UCs) at 18 units in 10 European countries. Escherichia coli was the most frequent bacterium isolated from UCs; however, in 10/16 hospitals and in 6/15 community settings, E. coli was isolated in less than 50 % of the total positive UCs. Other bacterial strains were Klebsiella, Enterococcus, Proteus and Pseudomonas not only from hospital settings. E. coli showed a high resistance to amoxicillin and trimethoprim and variable to cephalosporin. Nitrofurantoin had a good rate of efficacy, with 11/16 hospitals and 11/14 community settings reporting a resistance lower than 5 %.