Urinary Tract Infections
Conditions
Keywords
Enterobacteria, Children, Febrile urinary tract infection, Cystitis, Extended-spectrum beta-lactamase-producing Enterobacteriaceae
Brief summary
Urinary tract infection due to Extended-spectrum beta-lactamase producing enterobacteriaceae (E-ESBL UTI) become a frequent problem. A too large variety in the prescription of antibiotics for E-ESBL UTI in children and absolute recommendations regarding the optimal treatment of E-ESBL is nearly impossible at this time. Our aim was to describe the characteristics and treatments of urinary tract infections caused by Extended spectrum betalactamase-producing Enterobacteriaceae in children.
Detailed description
In this prospective observational study between March 2013 and March 2017, children (0 to 18 years) with ESBL-E UTI were enrolled in 24 pediatric departments in France. Clinical and biological characteristics, risk factors of infection of E-ESBL, first and second lines of antibiotic therapies were analyzed. The investigators used the Kaplan-Meier method to estimate the time to fever defervescence and hospitalization duration, and Log-rank test to assess equality of survivor functions. The investigators also analyzed the resistance patterns and molecular characterization of ESBL types in the isolates.
Interventions
None listed
Sponsors
Fouad Madhi
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 18 Years
Healthy volunteers
No
Inclusion criteria
* All inpatient or outpatient under 18 years with UTI (cystitis or febrile UTI) * Clinical signs associated with a positive E-ESBL in urine culture dependent urine collection method as previously described (Stein R, EAU/ESPU guidelines) and an antibiotic treatment targeting this strain.
Exclusion criteria
* Refusal to participate in the study * Children with mixed microbial strains and repeated infections were excluded
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| First and second lines used antibiotic therapies | at inclusion, at 3 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical characteristics (fewer, clinical sepsis) of E-ESBL UTI in children | at inclusion | — |
| Time to apyrexia (Kaplan-Meier method) | at inclusion | — |
| Length of hospital stay (Kaplan-Meier method) | at inclusion | — |
| Molecular characterization of ESBL types in the isolates | at inclusion | On the fisrt hundred urine samples |
| Clinical history of patient with E-ESBL UTI in children | at inclusion | — |
| Resistance patterns of ESBL types in the isolates | at inclusion | On the fisrt hundred urine samples |
| procalcitonin level of patient with E-ESBL UTI in children | at inclusion | — |
| Positive blood culture | at inclusion | — |
| cytobacteriological examination of the urine results | at inclusion, at 3 days | — |
| urine analysis by regent strip method | at inclusion | — |
| C reactive protein level of patient with E-ESBL UTI in children | at inclusion | — |
Countries
France
Outcome results
None listed