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Increased community-acquired upper urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli in children and the efficacy of flomoxef and cefmetazole
- Source :
- Clinical and Experimental Nephrology
- Publication Year :
- 2019
- Publisher :
- Springer Singapore, 2019.
-
Abstract
- Background Urinary tract infections caused by extended-spectrum beta-lactamase-producing bacteria are increasing worldwide. At our hospital, the number of pediatric patients hospitalized because of an upper urinary tract infection has dramatically increased since 2016. In total, 60.5% of urinary tract infections are caused by extended-spectrum beta-lactamase-producing Escherichia coli. Such a high prevalence of extended-spectrum beta-lactamase-producing E. coli has not been detected previously in Japan. Therefore, we evaluated the clinical and bacteriologic characteristics and efficacy of antibiotics against upper urinary tract infections caused by E. coli in children. Methods This retrospective study surveyed 152 patients who were hospitalized in the pediatric department of Shimane Prefectural Central Hospital because of upper urinary tract infections caused by E. coli. Medical records were reviewed to examine patient characteristics. O antigens, antibiotic susceptibility, gene typing, and pulse-field gel electrophoresis were studied at the Shimane Prefectural Institute of Public Health and Environmental Science. Results Urine sample analyses showed extended-spectrum beta-lactamase types such as CTX-M-9 and plural virulence genes. We changed the primary antibiotic treatment to flomoxef or cefmetazole to treat upper urinary tract infections caused by Gram-negative bacilli. After changing treatment, the time to fever alleviation was significantly shortened. Conclusion Extended-spectrum beta-lactamase-producing E. coli should be suspected in community-acquired upper urinary tract infections. Therefore, when treating patients, it is necessary to focus on antibiotic susceptibility and the prevalence of extended-spectrum beta-lactamase-producing bacteria found in each area. Flomoxef and cefmetazole are useful primary treatments for upper urinary tract infections caused by extended-spectrum beta-lactamase-producing E. coli.
- Subjects :
- Male
Physiology
medicine.medical_treatment
Antibiotics
030232 urology & nephrology
030204 cardiovascular system & hematology
Cefmetazole
medicine.disease_cause
0302 clinical medicine
Drug Resistance, Multiple, Bacterial
Child
Escherichia coli Infections
Upper urinary tract
Virulence
Escherichia coli Proteins
O Antigens
Anti-Bacterial Agents
Community-Acquired Infections
Nephrology
Child, Preschool
Urinary Tract Infections
Original Article
Female
Upper urinary tract infection
medicine.drug
Escherichia
medicine.medical_specialty
Adolescent
Genotype
medicine.drug_class
Urinary system
beta-Lactamases
03 medical and health sciences
Physiology (medical)
Internal medicine
Flomoxef
medicine
Humans
Escherichia coli
Retrospective Studies
business.industry
Infant, Newborn
Infant
Cephalosporins
Extended-spectrum beta-lactamase-producing escherichia coli
Beta-lactamase
business
Subjects
Details
- Language :
- English
- ISSN :
- 14377799 and 13421751
- Volume :
- 23
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Clinical and Experimental Nephrology
- Accession number :
- edsair.doi.dedup.....8ae25f70c9814573a09cbcae847e31aa