TY - JOUR
T1 - Pathogens causing urinary tract infections in infants
T2 - a European overview by the ESCAPE study group
AU - Alberici, Irene
AU - Bayazit, Aysun Karabay
AU - Drozdz, Dorota
AU - Emre, Sevinç
AU - Fischbach, Michel
AU - Harambat, Jérôme
AU - Jankauskiene, Augustina
AU - Litwin, Mieczyslaw
AU - Mir, Sevgi
AU - Morello, William
AU - Peco-Antic, Amira
AU - Sallay, Peter
AU - Sever, Lale
AU - Simonetti, Giacomo D.
AU - Szczesniak, Przemyslaw
AU - Teixeira, Ana
AU - Vidal, Enrico
AU - Wuehl, Elke
AU - Mehls, Otto
AU - Weber, Lutz T.
AU - Schaefer, Franz
AU - Montini, Giovanni
PY - 2015/11/28
Y1 - 2015/11/28
N2 - Knowledge of the distribution spectrum of causative organisms and their resistance patterns has become a core requirement for the rational and effective management of urinary tract infections. In the context of a prospective trial on the use of antibiotic prophylaxis in infants with underling kidney malformations, we conducted an online survey among paediatric nephrologists on positive urine cultures (July 2010–June 2012) from both hospitalized and non-hospitalized infants under 24 months of age. We collected 4745 urine cultures (UCs) at 18 units in 10 European countries. Escherichia coli was the most frequent bacterium isolated from UCs; however, in 10/16 hospitals and in 6/15 community settings, E. coli was isolated in less than 50 % of the total positive UCs. Other bacterial strains were Klebsiella, Enterococcus, Proteus and Pseudomonas not only from hospital settings. E. coli showed a high resistance to amoxicillin and trimethoprim and variable to cephalosporin. Nitrofurantoin had a good rate of efficacy, with 11/16 hospitals and 11/14 community settings reporting a resistance lower than 5 %. Conclusion: E. coli is the most common organism causing UTIs in infants; however, other bacterial strains are frequently isolated. As a result, antibiotic prophylaxis should be more elastic and adaptable over time in order to guarantee maximum efficacy.
AB - Knowledge of the distribution spectrum of causative organisms and their resistance patterns has become a core requirement for the rational and effective management of urinary tract infections. In the context of a prospective trial on the use of antibiotic prophylaxis in infants with underling kidney malformations, we conducted an online survey among paediatric nephrologists on positive urine cultures (July 2010–June 2012) from both hospitalized and non-hospitalized infants under 24 months of age. We collected 4745 urine cultures (UCs) at 18 units in 10 European countries. Escherichia coli was the most frequent bacterium isolated from UCs; however, in 10/16 hospitals and in 6/15 community settings, E. coli was isolated in less than 50 % of the total positive UCs. Other bacterial strains were Klebsiella, Enterococcus, Proteus and Pseudomonas not only from hospital settings. E. coli showed a high resistance to amoxicillin and trimethoprim and variable to cephalosporin. Nitrofurantoin had a good rate of efficacy, with 11/16 hospitals and 11/14 community settings reporting a resistance lower than 5 %. Conclusion: E. coli is the most common organism causing UTIs in infants; however, other bacterial strains are frequently isolated. As a result, antibiotic prophylaxis should be more elastic and adaptable over time in order to guarantee maximum efficacy.
KW - Antibiotic resistance
KW - Escherichia coli
KW - Infants
KW - Urinary tract infection
KW - Urine culture
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U2 - 10.1007/s00431-014-2459-3
DO - 10.1007/s00431-014-2459-3
M3 - Article
C2 - 25428232
AN - SCOPUS:84929836225
VL - 174
SP - 783
EP - 790
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
IS - 6
ER -