Urinary tract infections caused by extended-spectrum beta-lactamase-producing bacteria in children: a matched case-control study

Extended-spectrum beta-lactamase (ESBL)-producing pathogens are emerging as a cause of urinary tract infections (UTI) worldwide. In this matched-case control study, clinical characteristics and associated risk factors for ESBL UTI were evaluated. In a total of 463 positive urine cultures, 48 (10.4%) (from 39 patients, 23 boys) were phenotypically ESBL-producing bacteria. The most frequently isolated microorganism was , followed by Klebsiella spp. and Enterobacter cloacae. Children with ESBL UTI (n=39) were on prophylaxis more (21% vs. 6%, p=0.01), had higher rates of urinary tract anomalies (36% vs. 10%, p=0.0007), presented abnormal 99m Tcdimercaptosuccinic acid (DMSA) findings (i.e. scars) (23% vs. 4%, p=0.001), and had longer hospitalization (9.8 vs. 7.4 days, p=0.004) compared to those with non-ESBL UTI (n=117). The recognition of risk factors for UTI caused by ESBL bacteria in children may aid in the identification of high-risk cases and may enable proper management of these patients.