Analysis of drug resistance of extended-spectrum beta-lactamases-producing Escherichia coli and Klebsiella pneumoniae in children with urinary tract infection

• Published in: Saudi medical journal Vol. 40; no. 11; pp. 1111 - 1115
• Main Authors: Keshi, Lu, Weiwei, Xiao, Shoulin, Li, Xiadong, Liu, Hao, Wang, Junhai, Jiang, Xiangwei, Wang, Rui, Wang, Pei, Zhu
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Saudi Medical Journal 01.11.2019; Prince Sultan Military Medical City (PSMMC)
• Subjects: Amikacin; Analysis; Antibacterial agents; Antibiotics; Bacteria; Bacterial infections; Beta lactamases; Cefotetan; Child; Children; Drug resistance; Drug Resistance, Bacterial; Escherichia coli - drug effects; Hospital patients; Humans; Imipenem; Infection; Klebsiella pneumoniae - drug effects; Meropenem; Microbial drug resistance; Microbial Sensitivity Tests; Original; Pediatrics; Pneumonia; Retrospective Studies; Sulbactam; Tazobactam; Urinary tract infections; Urinary Tract Infections - microbiology; China
• ISSN: 0379-5284; 1658-3175
• DOI: 10.15537/smj.2019.11.24547

To investigate the drug resistance of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli ) and Klebsiella pneumoniae (K. pneumoniae) in children with urinary tract infection  (UTI) and to provide the rationale for clinical use of antibiotics. This is a retrospective analysis of drug susceptibility in children with E. coli or K. pneumoniae-positive urine culture between August 2013 and August 2017,  Shenzhen Children's Hospital, Shenzhen, China. Drug resistance was statistically assessed using Fisher exact test and χ2 test. A total of 698 cases of E. coli, 426 of which were confirmed ESBL-producing strains, and 217 cases of K. pneumoniae, including 111 ESBL-producing strains, were detected, and the difference in proportion of positive ESBL-producing strains (61.03% versus 51.15%) was statistically significant (p=0.010). The average drug resistance rates of E. coli and K. pneumoniae to piperacillin/tazobactam, meropenem, ertapenem, imipenem, and amikacin were less than 15%. The average resistance rates of ESBL-producing E. coli and K. pneumoniae to cefpodoxime, cefixime, cefazolin, and ceftriaxone was less than 98%, while average resistance rates for non-ESBL-producing bacteria to the above 4 drugs was less than 20%. In southern China, the proportion of ESBL-producing strains and the drug resistance rates of E. coli and K. pneumoniae in UTI in children was high, but their resistance rates to carbapenems and β-lactamase inhibitor complexes containing tazobactam were low. Carbapenems are the most effective antibacterial drugs for the treatment of ESBL-producing bacteria.