Community-onset extended-spectrum β-lactamase producing Escherichia coli in urinary tract infections in children from 2015 to 2016 Prevalence, risk factors, and resistances

Over the past 10 years, the resistances among microbes are increasing gradually in Europe and greater resistances are seen in southern countries. We studied the prevalence of community-onset ESBL-producing Escherichia coli urinary tract infections in children. As secondary objectives, we analyzed associated risk factors and the resistance patterns in ESBL-producing E coli isolates. Retrospective observational study in a tertiary care hospital about children <= 14 years old with community-onset E coli urinary tract infection. The variables studied were age, sex, ESBL-producing, antibiotic therapy 7 to 30 days before the infection, hospitalization 7 to 30 days before the infection, nefrourologic pathology, and vesicoureteral reflux. Between January 1st, 2015 and December 31st, 2016, 229 isolates of E coli were obtained, of whom 21 (9.2%) where ESBL-producing E coli. Median age in non-ESBL-producing was 18 months versus 7 months in ESBL-producing group. Fourteen (66%) of the ESBL-producing group were men (P=.001), 5 (23.8%) were hospitalized 30 days before the infection (P=.001), 12 (57.1%) had nefrourological pathology (P=.003), 6 (28.5%) had vesicoureteral reflux (P=.032). Previous antibiotic therapy was not statistically significant. Multiple regression analyses between sex and 30 days previous hospitalization were r=3.51 (P=.0001). Multidrug resistant isolates among ESBL-producing E coli was 12 (57%). The retrospective study allowed assessing the problem of ESBL-producing isolates in the outpatient settings. Some risk factors from past studies were confirmed and a combined risk is suggested. The resistant spectrum should be taken into account when choosing antibiotic regimens.