Urinary Tract Infection Due to Beta-lactamase-producing Enterobacteriaceae in Children

Fouad Madhi590 enrolled

Overview

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.

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.

Study Type

OBSERVATIONAL

Enrollment

590

Conditions

Urinary Tract Infections

Eligibility

Sex: ALLMax age: 18 Years

Medical Language ↔ Plain English

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

Locations (24)

Hopital Ambroise Paré

Boulogne-Billancourt, France

Saint Camille Hospital

Bry-sur-Marne, France

Outcomes

Primary Outcomes

First and second lines used antibiotic therapies

Time frame: at inclusion, at 3 days

Secondary Outcomes

Resistance patterns of ESBL types in the isolates

On the fisrt hundred urine samples

Time frame: at inclusion

Clinical characteristics (fewer, clinical sepsis) of E-ESBL UTI in children

Time frame: at inclusion

Time to apyrexia (Kaplan-Meier method)

Time frame: at inclusion

Length of hospital stay (Kaplan-Meier method)

Time frame: at inclusion

Molecular characterization of ESBL types in the isolates

On the fisrt hundred urine samples

Time frame: at inclusion

Clinical history of patient with E-ESBL UTI in children

Time frame: at inclusion

C reactive protein level of patient with E-ESBL UTI in children

Time frame: at inclusion

procalcitonin level of patient with E-ESBL UTI in children

Time frame: at inclusion

Positive blood culture

Time frame: at inclusion

cytobacteriological examination of the urine results

Data from ClinicalTrials.gov

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