Efficacy of non-carbapenem antibiotics for pediatric patients with first febrile urinary tract infection due to extended-spectrum beta-lactamase-producing Escherichia coli.
In: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, Jg. 23 (2017-08-01), Heft 8, S. 517-522
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Zugriff:
Although carbapenem is the recommended for urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing organisms, non-carbapenems have been reported to be effective for adult patients with UTI caused by ESBL-producing organisms. The purpose of this study was to evaluate the efficacy of non-carbapenems for pediatric patients with UTI due to ESBL-producing Escherichia coli (E. coli) based on the microbiologic and clinical outcomes. Fifteen children, who were treated for first febrile UTI caused by ESBL-producing E. coli were enrolled in this study. Antimicrobial susceptibilities and ESBL production were determined according to the Clinical and Laboratory Standards Institute guidelines. To detect CTX-M genes, polymerase chain reaction was performed with specific primers for bla CTX-M detection. Of the 15 enrolled patients, 10 (66.7%) were boys and 5 (33.3%) were girls, with a median age of four months. VUR was detected in six patients (40%). For detection of bla CTX-M by PCR, CTX-M-3, CTX-M-8, CTX-M-14, and CTX-M-15 were detected in five, one, eight, and one patient, respectively. Overall, 14 of the 15 isolates (93.3%) were susceptible for fosfomycin (FOM), and all isolates were susceptible for cefmetazole (CMZ), flomoxef (FMOX), and imipenem/cilastatin (IPM/CS). Of the 15 patients, 12 (80%) clinically improved without the use of carbapenems. In conclusion, even if isolates of ESBL-producing E. coli are multidrug resistant based on MIC assessment, clinical susceptibility to non-carbapenems, such as CMZ, FMOX, and FOM, is possible. Accordingly, carbapenems may not be required all the time for treatment of pediatric UTI in clinical practice.
(Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Titel: |
Efficacy of non-carbapenem antibiotics for pediatric patients with first febrile urinary tract infection due to extended-spectrum beta-lactamase-producing Escherichia coli.
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Autor/in / Beteiligte Person: | Abe, Y ; Inan-Erdogan, I ; Fukuchi, K ; Wakabayashi, H ; Ogawa, Y ; Hibino, S ; Sakurai, S ; Matsuhashi, K ; Watanabe, Y ; Hashimoto, K ; Ugajin, K ; Itabashi, K |
Zeitschrift: | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, Jg. 23 (2017-08-01), Heft 8, S. 517-522 |
Veröffentlichung: | 2014- : Amsterdam : Elsevier ; <i>Original Publication</i>: Tokyo : New York : Published for the Society by Churchill Livingstone, c1995-, 2017 |
Medientyp: | academicJournal |
ISSN: | 1437-7780 (electronic) |
DOI: | 10.1016/j.jiac.2017.04.006 |
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