Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children
Objective To determine which children with urinary tract infection are likely to have pathogens resistant to narrow-spectrum antimicrobials. Study design Children, 2-71 months of age (n = 769) enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux or Careful Urinary Tract In...
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| Veröffentlicht in: | The Journal of pediatrics 2016-04, Vol.171, p.116-121 |
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| creator | Shaikh, Nader, MD, MPH Hoberman, Alejandro, MD Keren, Ron, MD Ivanova, Anastasia, PhD Gotman, Nathan, MS Chesney, Russell W., MD Carpenter, Myra A., PhD Moxey-Mims, Marva, MD Wald, Ellen R., MD |
| description | Objective To determine which children with urinary tract infection are likely to have pathogens resistant to narrow-spectrum antimicrobials. Study design Children, 2-71 months of age (n = 769) enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux or Careful Urinary Tract Infection Evaluation studies were included. We used logistic regression models to test the associations between demographic and clinical characteristics and resistance to narrow-spectrum antimicrobials. Results Of the included patients, 91% were female and 76% had vesicoureteral reflux. The risk of resistance to narrow-spectrum antibiotics in uncircumcised males was approximately 3 times that of females (OR 3.1; 95% CI 1.4-6.7); in children with bladder bowel dysfunction, the risk was 2 times that of children with normal function (OR 2.2; 95% CI 1.2-4.1). Children who had received 1 course of antibiotics during the past 6 months also had higher odds of harboring resistant organisms (OR 1.6; 95% CI 1.1-2.3). Hispanic children had higher odds of harboring pathogens resistant to some narrow-spectrum antimicrobials. Conclusions Uncircumcised males, Hispanic children, children with bladder bowel dysfunction, and children who received 1 course of antibiotics in the past 6 months were more likely to have a urinary tract infection caused by pathogens resistant to 1 or more narrow-spectrum antimicrobials. |
| doi_str_mv | 10.1016/j.jpeds.2015.12.044 |
| format | Article |
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Study design Children, 2-71 months of age (n = 769) enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux or Careful Urinary Tract Infection Evaluation studies were included. We used logistic regression models to test the associations between demographic and clinical characteristics and resistance to narrow-spectrum antimicrobials. Results Of the included patients, 91% were female and 76% had vesicoureteral reflux. The risk of resistance to narrow-spectrum antibiotics in uncircumcised males was approximately 3 times that of females (OR 3.1; 95% CI 1.4-6.7); in children with bladder bowel dysfunction, the risk was 2 times that of children with normal function (OR 2.2; 95% CI 1.2-4.1). Children who had received 1 course of antibiotics during the past 6 months also had higher odds of harboring resistant organisms (OR 1.6; 95% CI 1.1-2.3). Hispanic children had higher odds of harboring pathogens resistant to some narrow-spectrum antimicrobials. Conclusions Uncircumcised males, Hispanic children, children with bladder bowel dysfunction, and children who received 1 course of antibiotics in the past 6 months were more likely to have a urinary tract infection caused by pathogens resistant to 1 or more narrow-spectrum antimicrobials.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2015.12.044</identifier><identifier>PMID: 26794472</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Amoxicillin - pharmacology ; Anti-Infective Agents - pharmacology ; Cephalosporins - pharmacology ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Escherichia coli ; Female ; Humans ; Infant ; Intestinal Diseases - drug therapy ; Intestinal Diseases - epidemiology ; Intestinal Diseases - microbiology ; Male ; Nitrofurantoin - pharmacology ; Odds Ratio ; Pediatrics ; Regression Analysis ; Sulfamethoxazole - pharmacology ; Trimethoprim - pharmacology ; Urinary Tract Infections - drug therapy ; Urinary Tract Infections - epidemiology ; Urinary Tract Infections - microbiology ; Vesico-Ureteral Reflux - drug therapy ; Vesico-Ureteral Reflux - epidemiology ; Vesico-Ureteral Reflux - microbiology</subject><ispartof>The Journal of pediatrics, 2016-04, Vol.171, p.116-121</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c584t-640a1654614b2375d0da005f8d2e10195fe10ff714a0524f1c4eff22271ddcb33</citedby><cites>FETCH-LOGICAL-c584t-640a1654614b2375d0da005f8d2e10195fe10ff714a0524f1c4eff22271ddcb33</cites><orcidid>0000-0002-1602-343X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022347615016339$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26794472$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shaikh, Nader, MD, MPH</creatorcontrib><creatorcontrib>Hoberman, Alejandro, MD</creatorcontrib><creatorcontrib>Keren, Ron, MD</creatorcontrib><creatorcontrib>Ivanova, Anastasia, PhD</creatorcontrib><creatorcontrib>Gotman, Nathan, MS</creatorcontrib><creatorcontrib>Chesney, Russell W., MD</creatorcontrib><creatorcontrib>Carpenter, Myra A., PhD</creatorcontrib><creatorcontrib>Moxey-Mims, Marva, MD</creatorcontrib><creatorcontrib>Wald, Ellen R., MD</creatorcontrib><title>Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Objective To determine which children with urinary tract infection are likely to have pathogens resistant to narrow-spectrum antimicrobials. Study design Children, 2-71 months of age (n = 769) enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux or Careful Urinary Tract Infection Evaluation studies were included. We used logistic regression models to test the associations between demographic and clinical characteristics and resistance to narrow-spectrum antimicrobials. Results Of the included patients, 91% were female and 76% had vesicoureteral reflux. The risk of resistance to narrow-spectrum antibiotics in uncircumcised males was approximately 3 times that of females (OR 3.1; 95% CI 1.4-6.7); in children with bladder bowel dysfunction, the risk was 2 times that of children with normal function (OR 2.2; 95% CI 1.2-4.1). Children who had received 1 course of antibiotics during the past 6 months also had higher odds of harboring resistant organisms (OR 1.6; 95% CI 1.1-2.3). Hispanic children had higher odds of harboring pathogens resistant to some narrow-spectrum antimicrobials. Conclusions Uncircumcised males, Hispanic children, children with bladder bowel dysfunction, and children who received 1 course of antibiotics in the past 6 months were more likely to have a urinary tract infection caused by pathogens resistant to 1 or more narrow-spectrum antimicrobials.</description><subject>Amoxicillin - pharmacology</subject><subject>Anti-Infective Agents - pharmacology</subject><subject>Cephalosporins - pharmacology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Drug Resistance, Bacterial</subject><subject>Escherichia coli</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Intestinal Diseases - drug therapy</subject><subject>Intestinal Diseases - epidemiology</subject><subject>Intestinal Diseases - microbiology</subject><subject>Male</subject><subject>Nitrofurantoin - pharmacology</subject><subject>Odds Ratio</subject><subject>Pediatrics</subject><subject>Regression Analysis</subject><subject>Sulfamethoxazole - pharmacology</subject><subject>Trimethoprim - pharmacology</subject><subject>Urinary Tract Infections - drug therapy</subject><subject>Urinary Tract Infections - epidemiology</subject><subject>Urinary Tract Infections - microbiology</subject><subject>Vesico-Ureteral Reflux - drug therapy</subject><subject>Vesico-Ureteral Reflux - epidemiology</subject><subject>Vesico-Ureteral Reflux - microbiology</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkstuFDEQRS0EIkPgC5BQL9l041e_FkSKRjwiRSKCZG157PJMNd32YHdHyt_wLXwZHiZEwIaVJfveW-U6RchLRitGWfNmqIY92FRxyuqK8YpK-YisGO3bsumEeExWlHJeCtk2J-RZSgOltJeUPiUnvGl7KVu-IuYqgkUzh5iK4IpzP-OEJoYN6rH4DAnTrL2BQk_Bb4srPe_CFnwq1npJmG9uInod7358v47azMWFd2BmDL5AX6x3ONoI_jl54vSY4MX9eUpu3r-7Xn8sLz99uFifX5am7uRcNpJq1tSyYXLDRVtbajWltessh_zhvnb5cK5lUtOaS8eMBOc45y2z1myEOCVnx9z9spnAGvBz1KPaR5xyiypoVH-_eNypbbhVsqNdw7oc8Po-IIZvC6RZTZgMjKP2EJakWNs2De-ZrLNUHKV5VilFcA9lGFUHPGpQv_CoAx7FuMp4suvVnx0-eH7zyIK3RwHkOd0iRJUMQgZgMebBKhvwPwXO_vGbET0aPX6FO0hDWKLPCBRTKRvUl8OGHBaE1TlRiF78BMX_uYI</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>Shaikh, Nader, MD, MPH</creator><creator>Hoberman, Alejandro, MD</creator><creator>Keren, Ron, MD</creator><creator>Ivanova, Anastasia, PhD</creator><creator>Gotman, Nathan, MS</creator><creator>Chesney, Russell W., MD</creator><creator>Carpenter, Myra A., PhD</creator><creator>Moxey-Mims, Marva, MD</creator><creator>Wald, Ellen R., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1602-343X</orcidid></search><sort><creationdate>20160401</creationdate><title>Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children</title><author>Shaikh, Nader, MD, MPH ; Hoberman, Alejandro, MD ; Keren, Ron, MD ; Ivanova, Anastasia, PhD ; Gotman, Nathan, MS ; Chesney, Russell W., MD ; Carpenter, Myra A., PhD ; Moxey-Mims, Marva, MD ; Wald, Ellen R., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c584t-640a1654614b2375d0da005f8d2e10195fe10ff714a0524f1c4eff22271ddcb33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Amoxicillin - pharmacology</topic><topic>Anti-Infective Agents - pharmacology</topic><topic>Cephalosporins - pharmacology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Drug Resistance, Bacterial</topic><topic>Escherichia coli</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Intestinal Diseases - drug therapy</topic><topic>Intestinal Diseases - epidemiology</topic><topic>Intestinal Diseases - microbiology</topic><topic>Male</topic><topic>Nitrofurantoin - pharmacology</topic><topic>Odds Ratio</topic><topic>Pediatrics</topic><topic>Regression Analysis</topic><topic>Sulfamethoxazole - pharmacology</topic><topic>Trimethoprim - pharmacology</topic><topic>Urinary Tract Infections - drug therapy</topic><topic>Urinary Tract Infections - epidemiology</topic><topic>Urinary Tract Infections - microbiology</topic><topic>Vesico-Ureteral Reflux - drug therapy</topic><topic>Vesico-Ureteral Reflux - epidemiology</topic><topic>Vesico-Ureteral Reflux - microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaikh, Nader, MD, MPH</creatorcontrib><creatorcontrib>Hoberman, Alejandro, MD</creatorcontrib><creatorcontrib>Keren, Ron, MD</creatorcontrib><creatorcontrib>Ivanova, Anastasia, PhD</creatorcontrib><creatorcontrib>Gotman, Nathan, MS</creatorcontrib><creatorcontrib>Chesney, Russell W., MD</creatorcontrib><creatorcontrib>Carpenter, Myra A., PhD</creatorcontrib><creatorcontrib>Moxey-Mims, Marva, MD</creatorcontrib><creatorcontrib>Wald, Ellen R., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shaikh, Nader, MD, MPH</au><au>Hoberman, Alejandro, MD</au><au>Keren, Ron, MD</au><au>Ivanova, Anastasia, PhD</au><au>Gotman, Nathan, MS</au><au>Chesney, Russell W., MD</au><au>Carpenter, Myra A., PhD</au><au>Moxey-Mims, Marva, MD</au><au>Wald, Ellen R., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>171</volume><spage>116</spage><epage>121</epage><pages>116-121</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>Objective To determine which children with urinary tract infection are likely to have pathogens resistant to narrow-spectrum antimicrobials. Study design Children, 2-71 months of age (n = 769) enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux or Careful Urinary Tract Infection Evaluation studies were included. We used logistic regression models to test the associations between demographic and clinical characteristics and resistance to narrow-spectrum antimicrobials. Results Of the included patients, 91% were female and 76% had vesicoureteral reflux. The risk of resistance to narrow-spectrum antibiotics in uncircumcised males was approximately 3 times that of females (OR 3.1; 95% CI 1.4-6.7); in children with bladder bowel dysfunction, the risk was 2 times that of children with normal function (OR 2.2; 95% CI 1.2-4.1). Children who had received 1 course of antibiotics during the past 6 months also had higher odds of harboring resistant organisms (OR 1.6; 95% CI 1.1-2.3). Hispanic children had higher odds of harboring pathogens resistant to some narrow-spectrum antimicrobials. Conclusions Uncircumcised males, Hispanic children, children with bladder bowel dysfunction, and children who received 1 course of antibiotics in the past 6 months were more likely to have a urinary tract infection caused by pathogens resistant to 1 or more narrow-spectrum antimicrobials.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26794472</pmid><doi>10.1016/j.jpeds.2015.12.044</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-1602-343X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Amoxicillin - pharmacology Anti-Infective Agents - pharmacology Cephalosporins - pharmacology Child Child, Preschool Drug Resistance, Bacterial Escherichia coli Female Humans Infant Intestinal Diseases - drug therapy Intestinal Diseases - epidemiology Intestinal Diseases - microbiology Male Nitrofurantoin - pharmacology Odds Ratio Pediatrics Regression Analysis Sulfamethoxazole - pharmacology Trimethoprim - pharmacology Urinary Tract Infections - drug therapy Urinary Tract Infections - epidemiology Urinary Tract Infections - microbiology Vesico-Ureteral Reflux - drug therapy Vesico-Ureteral Reflux - epidemiology Vesico-Ureteral Reflux - microbiology |
| title | Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children |
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