TY - JOUR AU - Simões, Ana AU - Lima, Margarida AU - Brett, Ana AU - Queiroz, Carolina AU - Chaves, Catarina AU - Oliveira, Henrique AU - Januário, Luís AU - Rodrigues, Fernanda PY - 2020/07/01 Y2 - 2024/03/28 TI - Urinary Tract Infections Caused by Community-Acquired Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in a Level III Hospital - A Retrospective Study JF - Acta Médica Portuguesa JA - Acta Med Port VL - 33 IS - 7-8 SE - Original DO - 10.20344/amp.12338 UR - https://actamedicaportuguesa.com/revista/index.php/amp/article/view/12338 SP - 466-474 AB - <p><strong>Introduction:</strong> The emergence of β-lactamases producing bacteria is a problem worldwide, with increasing importance in communityacquired infections, especially in urinary tract infections. Data regarding the use of non-carbapenem antimicrobials in these infections are scarce. The aim of this study was to analyse the treatment and outcome of urinary tract infections caused by community-acquired β-lactamase-producing bacteria in children.<br /><strong>Material and Methods:</strong> Retrospective study performed in a level III paediatric hospital, between June 2007 and December 2017. All children with β-lactamase-producing Enterobacteriaceae identified in aseptically collected urine culture were included.<br /><strong>Results:</strong> A total of 175 urinary infections caused by β-lactamases producing bacteria were diagnosed, 34 (19%) were community-acquired: 25 Escherichia coli (74%), 4 Klebsiella pneumoniae (12%), 4 Proteus mirabilis (12%) and 1 Proteus vulgaris (3%). In 30 (88%) cases, it was the first urinary infection. After identification of the microorganism and antimicrobial susceptibility, 33 (97%) children were re-evaluated and 24 (71%) had a repeat urine culture, which was positive in three (13%). In six (18%) cases, antibiotic treatment was modified. Four (12%) children had another UTI in the following month. In 30 (88%) children, imaging was carried out, with no nephrourological malformations detected.<br /><strong>Discussion:</strong> In the last decade, about 20% of urinary infections caused by β-lactamase-producing Enterobacteriaceae were community-acquired with a relatively stable number of cases over the years. No nephro-urological malformations were identified in these children.<br /><strong>Conclusion:</strong> Although the number of cases is small, the clinical and microbiological outcomes showed that most were successfully treated with non-carbapenem antibiotics, with low recurrence of new episodes of urinary tract infections.</p> ER -