Clinical Outcomes of Non-carbapenem Treatment for Urinary Tract Infections Caused by Extended-spectrum β-lactamase-producing Escherichia coli
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Purpose: The purpose of this study was to investigate the clinical outcomes of non-carbapenem treatment for urinary tract infections (UTIs) caused by extendedspectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli ) in young children. Methods: We retrospectively reviewed the medical records of children under 2 years of age who were diagnosed and treated for UTIs caused by ESBL-producing E. coli from September 2014 to March 2020. Results: Forty-three children under 2 years of age were treated with non-carbapenem antimicrobials for UTIs caused by ESBL-producing E. coli without bloodstream infections. The overall clinical and microbiological success rates for empirical antimicrobial treatment were 90.7% and 97.7%. Three of the patients (7.0%) experienced a relapse of UTI within a month. An in vitro susceptibility test showed that two patients were sensitive and one was resistant to the antimicrobial treatments. Furthermore, there were no significant differences in the time to defervescence, clinical success, microbiological success, and relapse rate between the susceptible (n=13) and non-susceptible groups (n=30). Conclusion: In this study, the overall relapse rate of patients treated with noncarbapenem antimicrobials was 7.0%. The patients showed high success rates in the clinical and microbiological responses to the non-carbapenems regardless of the results of the in vitro antimicrobial susceptibility test. These results provide evidence that non-carbapenems may be viable alternative treatments for UTIs caused by ESBL-producing E. coli .
Abstract
Purpose: The purpose of this study was to investigate the clinical outcomes of non-carbapenem treatment for urinary tract infections (UTIs) caused by extendedspectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli ) in young children. Methods: We retrospectively reviewed the medical records of children under 2 years of age who were diagnosed and treated for UTIs caused by ESBL-producing E. coli from September 2014 to March 2020. Results: Forty-three children under 2 years of age were treated with non-carbapenem antimicrobials for UTIs caused by ESBL-producing E. coli without bloodstream infections. The overall clinical and microbiological success rates for empirical antimicrobial treatment were 90.7% and 97.7%. Three of the patients (7.0%) experienced a relapse of UTI within a month. An in vitro susceptibility test showed that two patients were sensitive and one was resistant to the antimicrobial treatments. Furthermore, there were no significant differences in the time to defervescence, clinical success, microbiological success, and relapse rate between the susceptible (n=13) and non-susceptible groups (n=30). Conclusion: In this study, the overall relapse rate of patients treated with noncarbapenem antimicrobials was 7.0%. The patients showed high success rates in the clinical and microbiological responses to the non-carbapenems regardless of the results of the in vitro antimicrobial susceptibility test. These results provide evidence that non-carbapenems may be viable alternative treatments for UTIs caused by ESBL-producing E. coli .
참고문헌 (35)
- Zorc JJ, "Diagnosis and management of pediatric urinary tract infections", Clin Microbiol Rev, 18, pp.417~422 (2005)
- Briongos-Figuero LS, "Epidemiology, risk factors and comorbidity for urinary tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing enterobacteria", Int J Clin Pract, 66, pp.891~896 (2012)
- Jean SS, "Epidemiology and antimicrobial susceptibility profiles of pathogens causing urinary tract infections in the Asia-Pacific region:Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2010-2013", Int J Antimicrob Agents, 47, pp.328~334 (2016)
- Megged O, "Extended-spectrum β-lactamase-producing bacteria causing community-acquired urinary tract infections in children", Pediatr Nephrol, 29, pp.1583~1587 (2014)
- Fan NC, "Rise of community-onset urinary tract infection caused by extendedspectrum β-lactamase-producing Escherichia coli in children", J Microbiol Immunol Infect, 47, pp.399~405 (2014)
- Oteo J, "Extended-spectrum(beta)-lactamase producing Escherichia coli : changing epidemiology and clinical impact", Curr Opin Infect Dis, 23, pp.320~326 (2010)
- Wong-Beringer A, "Molecular correlation for the treatment outcomes in bloodstream infections caused by Escherichia coli and Klebsiella pneumoniae with reduced susceptibility to ceftazidime", Clin Infect Dis, 34, pp.135~146 (2002)
- Tinelli M, "Epidemiology and genetic characteristics of extendedspectrum β-lactamase-producing Gram-negative bacteria causing urinary tract infections in long-term care facilities", J Antimicrob Chemother, 67, pp.2982~2987 (2012)
- Papp-Wallace KM, "Carbapenems:past, present, and future", Antimicrob Agents Chemother, 55, pp.4943~4960 (2011)
- Ramphal R, "Extended-spectrum beta-lactamases and clinical outcomes : current data", Clin Infect Dis, 42(Suppl 4), pp.S164~S172 (2006)
- Apisarnthanarak A, "Carbapenem-resistant Gram-negative bacteria : how to prioritize infection prevention and control interventions in resourcelimited settings", Expert Rev Anti Infect Ther, 11, pp.147~157 (2013)
- Poirel L, "Carbapenem resistance in Acinetobacter baumannii : mechanisms and epidemiology", Clin Microbiol Infect, 12, pp.826~836 (2006)
- 박지영, "Should we prescribe carbapenem for treating febrile urinary tract infection caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in children with vesicoureteral reflux?", Clinical and Experimental Pediatrics, 64(6), pp.284~285 (2021), 대한소아청소년과학회[DOI]
- Doi A, "The efficacy of cefmetazole against pyelonephritis caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae", Int J Infect Dis, 17, pp.e159~e163 (2013)
- Sethaphanich N, "Pediatric extended spectrum β-lactamase infection : Community-acquired infection and treatment options", Pediatr Int, 58, pp.338~346 (2016)
- Guet-Revillet H, "Pharmacological study of cefoxitin as an alternative antibiotic therapy to carbapenems in treatment of urinary tract infections due to extended-spectrum-β-lactamaseproducing Escherichia coli", Antimicrob Agents Chemother, 58, pp.4899~4901 (2014)
- Peco-Antić A, "In vivo susceptibility of ESBL producing Escherichia coli to ceftriaxone in children with acute pyelonephritis", Srp Arh Celok Lek, 140, pp.321~325 (2012)
- Gentry LO, "Cephalosporins in urinary tract infection", Drugs, 34(Suppl 2), pp.154~163 (1987)
- Vinks AA, "Fundamentals of antimicrobial pharmacokinetics and pharmacodynamics", pp.137~146 (2014), Springer
- Tratselas A, "Outcome of urinary tract infections caused by extended spectrum β-lactamase-producing Enterobacteriaceae in children", Pediatr Infect Dis J, 30, pp.707~710 (2011)
- 이봉진, "Outcome of Antimicrobial Therapy of Pediatric Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae", Infection and Chemotherapy, 45(4), pp.415~421 (2013), 대한감염학회[DOI]
- Han SB, "Aminoglycoside therapy for childhood urinary tract infection due to extendedspectrum β-lactamase-producing Escherichia coli or Klebsiella pneumoniae", BMC Infect Dis, 15, pp.414~ (2015)
- Hyun HS, "Low relapse rate of urinary tract infections from extended-spectrum beta-lactamase-producing bacteria in young children", Pediatr Nephrol, 34, pp.2399~2407 (2019)
- CLSI, "CLSI supplement M100" (2014), Clinical and Laboratory Standards Institute
- Rupp ME, "Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae: considerations for diagnosis, prevention and drug treatment", Drugs, 63, pp.353~365 (2003)
- Vardakas KZ, "Carbapenems versus alternative antibiotics for the treatment of bacteraemia due to Enterobacteriaceae producing extended-spectrum β-lactamases : a systematic review and meta-analysis", J Antimicrob Chemother, 67, pp.2793~2803 (2012)
- Nordmann P, "Global spread of Carbapenemaseproducing Enterobacteriaceae", Emerg Infect Dis, 17, pp.1791~1798 (2011)
- Pitout JD, "Extended-spectrum beta-lactamaseproducing Enterobacteriaceae : an emerging public-health concern", Lancet Infect Dis, 8, pp.159~166 (2008)
- Roberts KB, "Urinary tract infection : clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months", Pediatrics, 128, pp.595~610 (2011)
- Helm RE, "Accepted but Unacceptable : Peripheral IV Catheter Failure : 2019 Follow-up", J Infus Nurs, 42, pp.149~150 (2019)
- Ullman AJ, "Complications of Central Venous Access Devices : A Systematic Review", Pediatrics, 136, pp.e1331~e1344 (2015)
- Tamma PD, "The Use of Noncarbapenem β-Lactams for the Treatment of Extended-Spectrum β-Lactamase Infections", Clin Infect Dis, 64, pp.972~980 (2017)
- Pilmis B, "Alternatives to carbapenems for infections caused by ESBL-producing Enterobacteriaceae", Eur J Clin Microbiol Infect Dis, 33, pp.1263~1265 (2014)
- Sharara SL, "Is Piperacillin-Tazobactam Effective for the Treatment of Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing Organisms?", Clin Infect Dis, 71, pp.e331~ (2020)
- Son SK, "Clinical effectiveness of carbapenems versus alternative antibiotics for treating ESBL-producing Enterobacteriaceae bacteraemia : a systematic review and meta-analysis", J Antimicrob Chemother, 73, pp.2631~2642 (2018)