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Original Articles

Risk factors and outcome of urinary tract infections by extended spectrum beta lactamase producing microorganisms in children

Authors:

Shami Kumar RP ,

Saveetha Medical College and Hospital, Chennai, Tamil Nadu, IN
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T. Ananya Sai Lakshmi

Rich Hospitals, Nellore, Andhra Pradesh,, IN
About T. Ananya

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Abstract

Objectives: To describe the outcome and risk factors for Urinary Tract Infection (UTI) caused by Extended Spectrum Beta Lactamase (ESBL) producing microorganisms, in children aged 2 months to 15 years, at a tertiary care centre in South India over a period of 1 year.


Method: During the study period, there were 352 children with UTI, of which 100 had ESBL UTI and they were included in the study. These 100 children were analysed for risk factors of UTI, nature of treatment, duration of hospital stay and response to treatment and these were recorded in the preformed proforma. Urine routine, urine culture and sensitivity, ultrasonogram, micturating cystourethrogram and dimercapto-succinic acid (DMSA) scan were done for all patients. If colony count was ≥105 colony forming units (CFUs) /ml on clean catch sample or urobag sample or any number in catheterized or suprapubic sample with significant ESBL strain growth on urine culture were recorded along with sensitivity pattern. Follow up was done for 3 months.


Results:Age and sex distribution of ESBL UTI were 20 (37%) boys and 13 (28.2) girls in the age group 2 months to 2 years, 15 (27.7%) boys and 15 (32.6%) girls in the age group 2 to 5 years, 12 (22.2%) boys and 5 (10.8%) girls in the age group 5 to 10 years and 7 (11.9%) boys and 13 (28.2%) girls in the age group 10 to 15 years. Common risk factors for ESBL UTI in our study were recent antibiotic use within the last 3 months (55%), previous UTI (40%), underlying renal problems (31%), recent hospitalization within the last 3 months (26%), antibiotic prophylaxis (24%), recent catheterization within the last 3 months (18%) and comorbidities (8%). Seventy patients were followed up after treatment for a period of 3 months. Among them 14 (20%) had another episode of UTI.


Conclusions: ESBL UTI was common in the age group 2 months to 2 years and was more common in males. Fever was the most common presentation. Underlying   renal   problems,   recent   antibiotic   use,   recent hospitalization, recent catheterization, previous UTI and antibiotic prophylaxis were found to be significant risk factors for ESBL UTI. Higher rates of pyelonephritis, voiding dysfunction, renal abnormalities and VUR were detected in ultrasonogram of patients with ESBL UTI. VUR was more common in patients with ESBL UTI. Renal scarring was more frequent in patients with ESBL UTI. Recurrence of UTI was more likely in patients with ESBL UTI.


Sri Lanka Journal of Child Health, 2022; 51(1): 92-98

How to Cite: Kumar RP, S. and Sai Lakshmi, T.A., 2022. Risk factors and outcome of urinary tract infections by extended spectrum beta lactamase producing microorganisms in children. Sri Lanka Journal of Child Health, 51(1), pp.92–98. DOI: http://doi.org/10.4038/sljch.v51i1.10002
Published on 05 Mar 2022.
Peer Reviewed

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