Emergence of antimicrobial-resistant uropathogens isolated from pediatric patients with cystitis on daily clean intermittent catheterization

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 21; no. 10; pp. 703 - 706
• Main Authors: Hiyama, Yoshiki, Takahashi, Satoshi, Uehara, Teruhisa, Hashimoto, Jiro, Nishinaka, Kazuyuki, Kitamura, Hiroshi, Masumori, Naoya
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.10.2015
• Subjects: Adolescent; beta-Lactamases; Child; Child, Preschool; Clean intermittent catheterization; Cystitis; Cystitis - etiology; Drug Resistance, Microbial; Equipment Contamination; Escherichia coli; Escherichia coli Infections - complications; Escherichia coli Infections - microbiology; Extended-spectrum β-lactamase; Female; Gram-Negative Bacteria - isolation & purification; Hematology, Oncology and Palliative Medicine; Humans; Infant; Infant, Newborn; Intermittent Urethral Catheterization - adverse effects; Proteus mirabilis; Staphylococcus aureus; Urinary tract infection; Urinary Tract Infections - complications; Urinary Tract Infections - microbiology; Urinary tract infection; Clean intermittent catheterization; Child; Extended-spectrum β-lactamase; Escherichia coli; Cystitis
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2015.06.006

Abstract One of the major complications of clean intermittent catheterization (CIC) is urinary tract infection (UTI). Recent reports showed that community-acquired UTIs caused by antimicrobial-resistant pathogens were gradually presenting in adults. However, there have been few reports about UTIs caused by antimicrobial-resistant bacteria in pediatric patients. Therefore, we retrospectively reviewed the medical charts of 45 children with CIC due to neurogenic bladder dysfunction from January 2010 to March 2013. Sixty-two episodes of cystitis occurred in 27 patients. Seventy bacterial strains were isolated from urine samples. The rate of Gram-negative bacteria was 84.3%. Six extended-spectrum β-lactamase (ESBL)-producing Escherichia coli ( E. coli ) strains were isolated from 4 patients. An ESBL-producing Proteus mirabilis strain and a methicillin-resistant Staphylococcus aureus strain were isolated from one patient each. Most of the pathogens of cystitis in the pediatric patients with CIC were Gram-negative bacilli, especially E. coli . We should be aware that ESBL producing E. coli as potential pathogens cause cystitis and regularly survey antimicrobial susceptibility to understand the resistant strains that develop.