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Febrile urinary-tract infection due to extended-spectrum beta-lactamase-producing enterobacteriaceae in children: a french prospective multicenter study
- Source :
- PLoS ONE, PLoS ONE, 2018, 13, pp.e0190910. ⟨10.1371/journal.pone.0190910⟩, PLoS ONE, Public Library of Science, 2018, 13, pp.e0190910. ⟨10.1371/journal.pone.0190910⟩, PLoS ONE, Vol 13, Iss 1, p e0190910 (2018)
- Publication Year :
- 2018
- Publisher :
- HAL CCSD, 2018.
-
Abstract
- Objectives To assess the management of febrile urinary-tract infection (FUTIs) due to extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-E) in children, the Pediatric Infectious Diseases Group of the French Pediatric Society set up an active surveillance network in pediatric centers across France in 2014. Materials and methods We prospectively analysed data from 2014 to 2016 for all children < 18 years old who received antibiotic treatment for FUTI due to ESBL-E in 24 pediatric centers. Baseline demographic, clinical features, microbiological data and antimicrobials prescribed were collected. Results 301 children were enrolled in this study. The median age was 1 year (IQR 0.02–17.9) and 44.5% were male. These infections occurred in children with history of UTIs (27.3%) and urinary malformations (32.6%). Recent antibiotic use was the main associated factor for FUTIs due to ESBL-E, followed by a previous hospitalization and travel history. Before drug susceptibility testing (DST), third-generation cephalosporins (3GC) PO/IV were the most-prescribed antibiotics (75.5%). Only 13% and 24% of children received amikacine alone for empirical or definitive therapy, respectively, whereas 88.7% of children had isolates susceptible to amikacin. In all, 23.2% of children received carbapenems in empirical and/or definitive therapy. Cotrimoxazole (24.5%), ciprofloxacin (15.6%) and non-orthodox clavulanate–cefixime combination (31.3%) were the most frequently prescribed oral options after obtaining the DST. The time to apyrexia and length of hospital stay did not differ with or without effective empirical therapy. Conclusions We believe that amikacin should increasingly take on a key role in the choice of definitive therapy of FUTI due to ESBL-E in children by avoiding the use of carbapenems.
- Subjects :
- Male
medicine.medical_treatment
Antibiotics
Cephalosporin
Urine
Pediatrics
0302 clinical medicine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Prospective Studies
lcsh:Science
Child
Enterobacteriaceae Infections
3. Good health
Ciprofloxacin
Child, Preschool
Pediatric Infectious Disease
Pediatric Infections
medicine.medical_specialty
Urinary system
030106 microbiology
Microbial Sensitivity Tests
Microbiology
03 medical and health sciences
Humans
Pharmacology
Bacteria
lcsh:R
Organisms
Infant
Biology and Life Sciences
bacterial infections and mycoses
Carbapenems
lcsh:Q
0301 basic medicine
Physiology
lcsh:Medicine
Risk Factors
Medicine and Health Sciences
Prospective cohort study
Multidisciplinary
Antimicrobials
Drugs
Anti-Bacterial Agents
Body Fluids
Amikacin
Urinary Tract Infections
Female
France
Anatomy
medicine.drug
Research Article
Adolescent
Fever
medicine.drug_class
Bladder
beta-Lactamases
Enterobacteriaceae
030225 pediatrics
Internal medicine
Microbial Control
medicine
book
[SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics
business.industry
Infant, Newborn
Kidneys
Renal System
Beta-lactamase
[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology
book.journal
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- PLoS ONE, PLoS ONE, 2018, 13, pp.e0190910. ⟨10.1371/journal.pone.0190910⟩, PLoS ONE, Public Library of Science, 2018, 13, pp.e0190910. ⟨10.1371/journal.pone.0190910⟩, PLoS ONE, Vol 13, Iss 1, p e0190910 (2018)
- Accession number :
- edsair.doi.dedup.....94318e538f53e159ccce7c386c4b675d