TY - JOUR
T1 - Urinary tract infection in infants caused by extended-spectrum beta-lactamase-producing Escherichia coli
T2 - comparison between urban and rural hospitals
AU - Cheng, Ming Fang
AU - Chen, Wan Ling
AU - Huang, I. Fei
AU - Chen, Jung Ren
AU - Chiou, Yee Hsuan
AU - Chen, Yao Shen
AU - Lee, Susan Shin Jung
AU - Hung, Wan Yu
AU - Hung, Chih Hsin
AU - Wang, Jiun Ling
N1 - Funding Information:
This study was supported by a grant (VGHKS104-082) from Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Publisher Copyright:
© 2016, IPNA.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background: Community-acquired urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is an emerging problem. Compared with urban infants, rural infants may encounter different distributions of community-acquired resistant strains and various barriers to efficient management. Methods: A retrospective survey and comparison was conducted for infants with UTI caused by ESBL-producing E. coli admitted to an urban hospital (n = 111) and a rural hospital (n = 48) in southern Taiwan from 2009 to 2012. Results: Compared with 2009 and 2010, the total number of cases at both hospitals significantly increased in 2011 and 2012 (p < 0.001). Compared with the rural patients, the urban patients were significantly younger, and they had fewer days of fever before and after admission, fewer presentations of poor activity and poor appetite, and a lower serum creatinine level. Most of the patients had no prior history of illness, and we could not identify any significant different risk factors for acquiring ESBL-producing E. coli, such as past antimicrobial use, hospitalization, UTI, and underlying renal diseases, between the urban and rural populations. Conclusions: The increase in community-acquired UTI in infants caused by ESBL-producing E. coli was similar between the urban and rural populations. Our preliminary data suggest that the rural–urban disparities were probably related to easy access to health care by the urban population. ESBL complicates disease management, and the increase in the prevalence of ESBL producers is a major health concern and requires further healthy carrier and environmental surveillance.
AB - Background: Community-acquired urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is an emerging problem. Compared with urban infants, rural infants may encounter different distributions of community-acquired resistant strains and various barriers to efficient management. Methods: A retrospective survey and comparison was conducted for infants with UTI caused by ESBL-producing E. coli admitted to an urban hospital (n = 111) and a rural hospital (n = 48) in southern Taiwan from 2009 to 2012. Results: Compared with 2009 and 2010, the total number of cases at both hospitals significantly increased in 2011 and 2012 (p < 0.001). Compared with the rural patients, the urban patients were significantly younger, and they had fewer days of fever before and after admission, fewer presentations of poor activity and poor appetite, and a lower serum creatinine level. Most of the patients had no prior history of illness, and we could not identify any significant different risk factors for acquiring ESBL-producing E. coli, such as past antimicrobial use, hospitalization, UTI, and underlying renal diseases, between the urban and rural populations. Conclusions: The increase in community-acquired UTI in infants caused by ESBL-producing E. coli was similar between the urban and rural populations. Our preliminary data suggest that the rural–urban disparities were probably related to easy access to health care by the urban population. ESBL complicates disease management, and the increase in the prevalence of ESBL producers is a major health concern and requires further healthy carrier and environmental surveillance.
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U2 - 10.1007/s00467-016-3338-0
DO - 10.1007/s00467-016-3338-0
M3 - Article
C2 - 26975387
AN - SCOPUS:84961193844
VL - 31
SP - 1305
EP - 1312
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 8
ER -