Clinical Significance of Extended-Spectrum beta-Lactamase Producing Escherichia coli in Pediatric Patients with Febrile Urinary Tract Infection

Park, Cheol; Kim, Min-Sang; Kim, Mi-Kyung; Yim, Hyung-Eun; Yoo, Kee-Hwan; Hong, Young-Sook; Lee, Joo-Won

doi:2012.16.1.38

J Korean Soc Pediatr Nephrol > Volume 16(1); 2012 > Article

J Korean Soc Pediatr Nephrol 2012;16(1): 38-45. doi: https://doi.org/10.3339/jkspn.2012.16.1.38

발열성 소아 요로감염에서 Extended-Spectrum β-Lactamase 생성 Escherichia coli의 임상적 의의

박철, 김민상, 김미경, 임형은, 유기환, 홍영숙, 이주원

¹고려대학교 의과대학 소아과학교실
²고려대학교 의과대학 소아과학교실
³고려대학교 의과대학 소아과학교실
⁴고려대학교 의과대학 소아과학교실
⁵고려대학교 의과대학 소아과학교실
⁶고려대학교 의과대학 소아과학교실
⁷고려대학교 의과대학 소아과학교실

Clinical Significance of Extended-Spectrum beta-Lactamase Producing Escherichia coli in Pediatric Patients with Febrile Urinary Tract Infection

Cheol Park, Min-Sang Kim, Mi-Kyung Kim, Hyung-Eun Yim, Kee-Hwan Yoo, Young-Sook Hong, Joo-Won Lee

¹Department of Pediatrics, Korea University
²Department of Pediatrics, Korea University
³Department of Pediatrics, Korea University
⁴Department of Pediatrics, Korea University
⁵Department of Pediatrics, Korea University
⁶Department of Pediatrics, Korea University
⁷Department of Pediatrics, Korea University

Received: March 8, 2012; Accepted: April 5, 2012.

ABSTRACT

PURPOSE: The incidence of community-acquired urinary tract infection (UTI) due to extended-spectrum beta-lactamase producing Escherichia coli (ESBL(+) E. coli) has increased worldwide. ESBL causes resistance to various types of the newer beta-lactam antibiotics, including the expanded spectrum cephalosporins and monobactams. We aimed to investigate the severity of UTI and associated genitourinary malformations in children with febrile UTI caused by ESBL(+) E. coli. METHODS: We retrospectively reviewed the medical records of 290 patients diagnosed as febrile UTI caused by E. coli between January 2008 and October 2010 at Korea University Medical center. We classified the patients into two groups with ESBL(+) and ESBL(-) E. coli group according to the sensitivity of urine culture. Fever duration, admission period, white blood cell (WBC) counts and C-reactive protein (CRP) in peripheral blood, the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR) and renal scar were compared between the two groups. RESULTS: Patients with ESBL(+) E. coli were 32, and those with ESBL(-) E. coli were 258. If we excluded those tested with a sterile urine bag, patients with ESBL(+) E. coli were 22, and those with ESBL(-) E. coli were 212. Whether the results of sterile urine bag tests were included or not, there was no significant difference in all parameters between the two groups statistically. CONCLUSION: Our data shows that ESBL(+) E. coli may not be related to the severity of UTI and associated genitourinary malformations.

Key words: Extended-spectrum beta-lactamase | Escherichia coli | Urinary tract infection