Prevalence, Risk Factors and Antibiotic Resistance of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Children Hospitalized with Urinary Tract Infection at King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | E. coli (Non-ESBL) | ESBL E. coli | p-Value |
---|---|---|---|
Mean ± SD or n (%) | Mean ± SD or n (%) | ||
Total (n = 192) | Total (n = 50) | ||
Sex | 0.121 | ||
Male | 62 (32.3%) | 22 (44%) | |
Female | 130 (67.7%) | 28 (56%) | |
Age: mean ± SD (years) | 5.1 ± 4.2 | 6.1 ± 4.6 | 0.091 |
Clinical presentation | |||
Length of hospital stay (days) | 4.8 ± 0.8 | 8.4 ± 1.2 | <0.001 |
Fever | 66 (34.4%) | 21 (42%) | 0.317 |
Urinary symptoms | 58 (30.2%) | 21 (42%) | 0.113 |
Urine analysis | |||
Pyuria | 57 (38%) | 19 (50%) | 0.178 |
Positive nitrites | 62 (41.6%) | 18 (48.6%) | 0.439 |
CBC | |||
WBC (K/µL) | 10.2 ± 5.8 | 9.4 ± 4.9 | 0.59 |
HB (g/dl) | 11.8 ± 2.8 | 11.1 ± 2.1 | 0.231 |
Platelets (K/µL) | 328.6 ± 161.4 | 346.9 ± 143.3 | 0.161 |
CRP (mg/L) | 26.1 ± 55.9 | 43.1 ± 73.7 | 0.032 |
BUN (mmol/L) | 4.7 ± 4.9 | 6.5 ± 7.5 | 0.114 |
Creatinine (µmol/L) | 43.2 ± 40.4 | 59.5 ± 64.3 | 0.605 |
Abnormal KUB US | 50 (56.8%) | 13 (50%) | 0.539 |
Abnormal VUCG | 11 (61.1%) | 8 (57.1%) | 0.821 |
Abnormal DMSA scan | 6 (75%) | 1 (20%) | 0.103 |
Variables | E. coli (Non ESBL) n (%) Total (n = 19) | ESBL E. coli n (%) Total (n = 50) | p-Value |
---|---|---|---|
Prior antibiotic use (last 3 months) | 100 (52.1%) | 36 (72%) | 0.011 |
Prior beta-lactam use (last 3 months) | 61 (31.8%) | 28 (56%) | 0.002 |
Prophylactic antibiotic use | 25 (13%) | 17 (34%) | <0.001 |
Prior UTI (last 3 months) | 85 (44.3%) | 31 (62%) | 0.025 |
Recurrent UTI | 93 (48.4%) | 40 (80%) | <0.001 |
Prior hospitalization (last 3 months) | 71 (37%) | 25 (50%) | 0.094 |
Prior GU surgery (last 3 months) | 31 (16.1%) | 6 (12%) | 0.468 |
Genitourinary abnormalities | 50 (26%) | 19 (38%) | 0.095 |
Urinary tract device | 10 (5.2%) | 2 (4%) | 1 |
Constipation | 17 (8.9%) | 5 (10%) | 0.785 |
Immunosuppression | 21 (10.9%) | 4 (8%) | 0.543 |
Co-morbidities | 136 (70.8%) | 44 (88%) | 0.013 |
Antibiotics | ESBL E. coli (Total n = 50) Resistance n (%) |
---|---|
Amoxicillin-clavulanate | 20 (40%) |
Ampicillin | 50 (100%) |
Piperacillin/tazobactam | 10 (20%) |
Third-generation cephalosporin (ceftriaxone) | 50 (100%) |
Amikacin | 1 (2%) |
Gentamicin | 11 (22%) |
Quinolone (ciprofloxacin) | 28 (56%) |
TMP/SMX | 32 (64%) |
Nitrofurantoin | 4 (8%) |
Meropenem | 0 (0%) |
Antibiotic Resistance (%) | Present Study, 2024 (Saudi Arabia) | Albaramki et al., 2019 (Jordan) [18] | Koçak et al., 2016 (Turkey) [19] | Collingwood et al., 2023 (USA) [3] | Vachvanichsanong et al., 2020 (Thailand) [14] | Pantha et al., 2024 (Nepal) [15] | Alsubaie et al., 2023 (Saudi Arabia) [12] | Altamimi et al., 2024 (Saudi Arabia) [16] |
---|---|---|---|---|---|---|---|---|
Amoxicillin-clavulanate | 40 | 94.8 | 85.7 | - | - | 100 | 40 | 96 |
Carbapenem | 0 a | 1.3 n | 0 b | 0 a | 0 a,b | 0 b | 0.7 a,b | 0 a |
Quinolone | 56 | 54.5 | 37.5 | 58.6 | - | 74 | 65 | 46 |
Nitrofurantoin | 8 | 53.2 | 50 | 14.8 | - | 5 | 32 | 18 |
Third-generation cephalosporin | 100 | 98.7 | 100 | - | 100 | 92 | - | 100 |
TMP/SMX | 64 | - | 71.4 | 65.7 | 68 | 74 | 72 | 67 |
Piperacillin/tazobactam | 20 | - | 51.8 | - | 22 | - | - | 18 |
Gentamicin | 22 | 54.5 | 25 | 36 | 58 | 32 | 21 | 28 |
Amikacin | 2 | 32.5 | 10.7 | - | 11 | - | 0.7 | 1 |
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Abdelgalil, A.; Saeedi, F.; Metwalli, E.; Almutairi, F.; Felemban, M.; Albaradei, H.; Aseeri, H.; Mokhtar, J.; Baw, W.; Sayed, M. Prevalence, Risk Factors and Antibiotic Resistance of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Children Hospitalized with Urinary Tract Infection at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Children 2024, 11, 1332. https://doi.org/10.3390/children11111332
Abdelgalil A, Saeedi F, Metwalli E, Almutairi F, Felemban M, Albaradei H, Aseeri H, Mokhtar J, Baw W, Sayed M. Prevalence, Risk Factors and Antibiotic Resistance of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Children Hospitalized with Urinary Tract Infection at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Children. 2024; 11(11):1332. https://doi.org/10.3390/children11111332
Chicago/Turabian StyleAbdelgalil, Abobakr, Fajr Saeedi, Eilaf Metwalli, Futoon Almutairi, Mayar Felemban, Hadeel Albaradei, Haneen Aseeri, Jawahir Mokhtar, Wesam Baw, and Mohamed Sayed. 2024. "Prevalence, Risk Factors and Antibiotic Resistance of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Children Hospitalized with Urinary Tract Infection at King Abdulaziz University Hospital, Jeddah, Saudi Arabia" Children 11, no. 11: 1332. https://doi.org/10.3390/children11111332
APA StyleAbdelgalil, A., Saeedi, F., Metwalli, E., Almutairi, F., Felemban, M., Albaradei, H., Aseeri, H., Mokhtar, J., Baw, W., & Sayed, M. (2024). Prevalence, Risk Factors and Antibiotic Resistance of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Children Hospitalized with Urinary Tract Infection at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Children, 11(11), 1332. https://doi.org/10.3390/children11111332