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The Journal of Pediatric Infectious Diseases and Immunology > Vol.33 No.4 contents > Abstract

Article in Japanese

Analysis of appropriate treatment for children with urinary tract infections when considering detection of ESBL-producing bacteria

Yoko SAKATA1), Tomohiro OISHI1), Ippei MIYATA1), Taichi KITANO1), Koujiro MITSUI1), Tomoki INOUE1), Kento TAKAHASHI1), Shoko WAKABAYASHI1), Mina KONO1), Atsushi KATO1), Hiroto AKAIKE1), Takaaki TANAKA2), Naoki OHNO1), Takashi NAKANO2), Kazun,obu OUCHI1)

This study analyzed the treatment of extended-spectrum β-lactamase (ESBL)‒producing bacterial urinary tract infections (UTIs) in children. It enrolled 211 children aged <15 years, who were admitted to this hospital for UTI treatment between October 2009 and December 2019. Escherichia coli was the most common pathogen (60.0%) among 121 bacterial strains detected. Of these, 23 were ESBL-producing E. coli (12.4%). Furthermore, the ratio of infections from these strains was significantly higher (17.4%) between 2016 and 2019 when compared to earlier years (p=0.0078). Age, frequency of urinary complications, history of pre-hospital antibiotic use, or oral preventive administrations were not significantly different amongst children with or without UTIisolated ESBL-producing E. coli. The sensitivity rates of injected antibiotics, PIPC/TAZ, CMZ and MEMP, and orally administered antibiotics, FRPM and FOM, were 100%. On the other hand, the sensitivity rates of other oral antibiotics, AMPC/CVA, ST and LVFX were 50%, 50%, and 38.9%, respectively. However, 92.3% of patients not using antibiotics to treat ESBL-producing E. coli resolved their fever within 72 h of therapy initiation.
Although the isolation rates of ESBL-producing E. coli among children with UTI have increased by more than 10% recently, their backgrounds and characteristics are unclear. Despite antibiotic resistance, most antibiotics used on children with UTI had high antipyretic efficacy. Therefore, we should use the cephems as the initial treatment for children with UTI along the current guidelines.

1)Department of Pediatrics, Kawasaki Medical School

2)Kawasaki Medical School General Medical Center

Key words ESBL, pediatrics, urinary tract infection
Received January 25, 2021
Accepted September 2, 2021

33 (4):333─343,2021