Febrile urinary-tract infection due to extended-spectrum beta-lactamase-producing Enterobacteriaceae in children: A French prospective multicenter study

被引:47
|
作者
Madhi, Fouad [1 ,2 ,3 ]
Jung, Camille [1 ,4 ]
Timsit, Sandra [5 ]
Levy, Corinne [2 ,3 ,4 ,6 ]
Biscardi, Sandra [2 ,3 ,7 ]
Lorrot, Mathie [2 ,8 ]
Grimprel, Emmanuel [2 ,9 ]
Hees, Laure [2 ,10 ]
Craiu, Irina [2 ,11 ]
Galerne, Aurelien [2 ,12 ]
Dubos, Francois [2 ,13 ]
Cixous, Emmanuel [2 ,14 ]
Hentgen, Veronique [2 ,15 ]
Bechet, Stephane [5 ]
Bonacorsi, Stephane [16 ]
Cohen, Robert [2 ,3 ,4 ,6 ,17 ]
机构
[1] Ctr Hosp Intercommunal Creteil, Serv Pediat Gen, Creteil, France
[2] SFP, GPIP, Paris, France
[3] Univ Paris Est, IMRB GRC GEMINI, Creteil, France
[4] Ctr Hosp Intercommunal Creteil, CRC, Creteil, France
[5] CHU Necker, Serv Urgences Pediat, Paris, France
[6] Assoc Clin & Therapeut Infantile Val de Marne, ACTIV, St Maur Des Fosses, France
[7] Ctr Hosp Intercommunal Creteil, Serv Urgences Pediat, Creteil, France
[8] CHU Robert Debre, Serv Pediat Gen, Paris, France
[9] CHU Trousseau, Serv Pediat Gen, Paris, France
[10] CHU Lyon, Serv Urgences Pediat, Lyon, France
[11] CHU Bicetre, Serv Urgences Pediat, Le Kremlin Bicetre, France
[12] CHU Jean Verdier, Serv Urgences Pediat, Bondy, France
[13] CHU Lille, Serv Urgences Pediat, Lille, France
[14] Ctr Hosp Roubaix, Serv Urgences Pediat, Roubaix, France
[15] Ctr Hosp Versailles, Serv Pediat Gen, Versailles, France
[16] Hop Robert Debre, AP HP, Microbiol Serv, Ctr Natl Reference Associe Escherichia Coli, Paris, France
[17] Ctr Hosp Intercommunal Creteil, Unite Court Sejour, Petits Nourrissons, Serv Neonatol, Creteil, France
来源
PLOS ONE | 2018年 / 13卷 / 01期
关键词
GRAM-NEGATIVE BACILLI; ESCHERICHIA-COLI; UNITED-STATES; ANTIMICROBIAL SUSCEPTIBILITY; MANAGEMENT; DIAGNOSIS; PYELONEPHRITIS; CLAVULANATE; TEMOCILLIN; CHILDHOOD;
D O I
10.1371/journal.pone.0190910
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objectives To assess the management of febrile urinary-tract infection (FUTIs) due to extended-spectrum beta-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.
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页数:14
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