Clinical Significance of Extended-Spectrum <TEX>${beta}$</TEX>-Lactamase Producing <TEX>$Escherichia$</TEX> <TEX>$coli$</TEX> 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 ${beta}$-Lactamase 생성 $Escherichia$ $coli$의 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