Predominant bacteria and patterns of antibiotic susceptibility in urinary tract infection in children with spina bifida

Tara K. Ortiz*, Nermarie Velazquez, Laura Ding, Jonathan C. Routh, John S. Wiener, Patrick Casey Seed, Sherry S. Ross

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Urinary tract infection is more common in children with spina bifida (SB) than neurologically intact children, and Escherichia coli is the most common urinary pathogen in the general pediatric population. Less is known of the pathogens responsible for urinary tract infections (UTI) in the pediatric SB population or their evolving antimicrobial resistance patterns. The goal of this study is to determine the epidemiology and antimicrobial resistance patterns of SB-associated urinary pathogens. Methods: Between January 1996 and August 2013, 231 patients aged 1 month to 18 years were identified with a diagnosis of SB-NB and at least one symptomatic urinary tract infection (UTI) event (Table). Two-hundred and thirty-one normally voiding children with a single symptomatic UTI were age-matched based on age at diagnosis of UTI at a 1:1 ratio. Chi-square tests and Generalized Estimating Equation analysis, controlling for clinicopathological factors, were performed to compare rates of pathogen-associations with UTI between groups and likelihood of UTI with multi-drug resistant (MDR) organisms. Results: Children in the SB-NB group had a higher rate of non-E. coli UTI compared with controls (64% vs. 41%, p < 0.01), particularly associated with Klebsiella species the SB-NB group had an overall higher infection rate with MDR organisms (21% vs. 10%, p < 0.01) and E. coli isolates, with a trend towards increased rates of antibiotic resistance to aminoglycosides, fluoroquinolones, cephalosporins, extended spectrum β-lactams, and TMP-SMZ. Additionally, patients in the SB-NB group had a 10-fold increase of urosepsis with 57% of events caused by MDR organisms. Conclusions: Children with SB-NB are more likely to have non-E. coli UTI, UTIs with MDR organisms, and urosepsis than the general pediatric population. [Table presented]

Original languageEnglish (US)
Pages (from-to)444.e1-444.e8
JournalJournal of Pediatric Urology
Volume14
Issue number5
DOIs
StatePublished - Oct 1 2018

Fingerprint

Spinal Dysraphism
Urinary Tract Infections
Anti-Bacterial Agents
Bacteria
Pediatrics
Pharmaceutical Preparations
Thymidine Monophosphate
Population
Escherichia coli
Lactams
Klebsiella
Fluoroquinolones
Aminoglycosides
Cephalosporins
Chi-Square Distribution
Microbial Drug Resistance
Epidemiology

Keywords

  • Escherichia coli
  • Multi-drug resistant
  • Neurogenic bladder
  • Spina bifida
  • Urinary tract infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Urology

Cite this

Ortiz, Tara K. ; Velazquez, Nermarie ; Ding, Laura ; Routh, Jonathan C. ; Wiener, John S. ; Seed, Patrick Casey ; Ross, Sherry S. / Predominant bacteria and patterns of antibiotic susceptibility in urinary tract infection in children with spina bifida. In: Journal of Pediatric Urology. 2018 ; Vol. 14, No. 5. pp. 444.e1-444.e8.
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title = "Predominant bacteria and patterns of antibiotic susceptibility in urinary tract infection in children with spina bifida",
abstract = "Background: Urinary tract infection is more common in children with spina bifida (SB) than neurologically intact children, and Escherichia coli is the most common urinary pathogen in the general pediatric population. Less is known of the pathogens responsible for urinary tract infections (UTI) in the pediatric SB population or their evolving antimicrobial resistance patterns. The goal of this study is to determine the epidemiology and antimicrobial resistance patterns of SB-associated urinary pathogens. Methods: Between January 1996 and August 2013, 231 patients aged 1 month to 18 years were identified with a diagnosis of SB-NB and at least one symptomatic urinary tract infection (UTI) event (Table). Two-hundred and thirty-one normally voiding children with a single symptomatic UTI were age-matched based on age at diagnosis of UTI at a 1:1 ratio. Chi-square tests and Generalized Estimating Equation analysis, controlling for clinicopathological factors, were performed to compare rates of pathogen-associations with UTI between groups and likelihood of UTI with multi-drug resistant (MDR) organisms. Results: Children in the SB-NB group had a higher rate of non-E. coli UTI compared with controls (64{\%} vs. 41{\%}, p < 0.01), particularly associated with Klebsiella species the SB-NB group had an overall higher infection rate with MDR organisms (21{\%} vs. 10{\%}, p < 0.01) and E. coli isolates, with a trend towards increased rates of antibiotic resistance to aminoglycosides, fluoroquinolones, cephalosporins, extended spectrum β-lactams, and TMP-SMZ. Additionally, patients in the SB-NB group had a 10-fold increase of urosepsis with 57{\%} of events caused by MDR organisms. Conclusions: Children with SB-NB are more likely to have non-E. coli UTI, UTIs with MDR organisms, and urosepsis than the general pediatric population. [Table presented]",
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author = "Ortiz, {Tara K.} and Nermarie Velazquez and Laura Ding and Routh, {Jonathan C.} and Wiener, {John S.} and Seed, {Patrick Casey} and Ross, {Sherry S.}",
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Predominant bacteria and patterns of antibiotic susceptibility in urinary tract infection in children with spina bifida. / Ortiz, Tara K.; Velazquez, Nermarie; Ding, Laura; Routh, Jonathan C.; Wiener, John S.; Seed, Patrick Casey; Ross, Sherry S.

In: Journal of Pediatric Urology, Vol. 14, No. 5, 01.10.2018, p. 444.e1-444.e8.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predominant bacteria and patterns of antibiotic susceptibility in urinary tract infection in children with spina bifida

AU - Ortiz, Tara K.

AU - Velazquez, Nermarie

AU - Ding, Laura

AU - Routh, Jonathan C.

AU - Wiener, John S.

AU - Seed, Patrick Casey

AU - Ross, Sherry S.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: Urinary tract infection is more common in children with spina bifida (SB) than neurologically intact children, and Escherichia coli is the most common urinary pathogen in the general pediatric population. Less is known of the pathogens responsible for urinary tract infections (UTI) in the pediatric SB population or their evolving antimicrobial resistance patterns. The goal of this study is to determine the epidemiology and antimicrobial resistance patterns of SB-associated urinary pathogens. Methods: Between January 1996 and August 2013, 231 patients aged 1 month to 18 years were identified with a diagnosis of SB-NB and at least one symptomatic urinary tract infection (UTI) event (Table). Two-hundred and thirty-one normally voiding children with a single symptomatic UTI were age-matched based on age at diagnosis of UTI at a 1:1 ratio. Chi-square tests and Generalized Estimating Equation analysis, controlling for clinicopathological factors, were performed to compare rates of pathogen-associations with UTI between groups and likelihood of UTI with multi-drug resistant (MDR) organisms. Results: Children in the SB-NB group had a higher rate of non-E. coli UTI compared with controls (64% vs. 41%, p < 0.01), particularly associated with Klebsiella species the SB-NB group had an overall higher infection rate with MDR organisms (21% vs. 10%, p < 0.01) and E. coli isolates, with a trend towards increased rates of antibiotic resistance to aminoglycosides, fluoroquinolones, cephalosporins, extended spectrum β-lactams, and TMP-SMZ. Additionally, patients in the SB-NB group had a 10-fold increase of urosepsis with 57% of events caused by MDR organisms. Conclusions: Children with SB-NB are more likely to have non-E. coli UTI, UTIs with MDR organisms, and urosepsis than the general pediatric population. [Table presented]

AB - Background: Urinary tract infection is more common in children with spina bifida (SB) than neurologically intact children, and Escherichia coli is the most common urinary pathogen in the general pediatric population. Less is known of the pathogens responsible for urinary tract infections (UTI) in the pediatric SB population or their evolving antimicrobial resistance patterns. The goal of this study is to determine the epidemiology and antimicrobial resistance patterns of SB-associated urinary pathogens. Methods: Between January 1996 and August 2013, 231 patients aged 1 month to 18 years were identified with a diagnosis of SB-NB and at least one symptomatic urinary tract infection (UTI) event (Table). Two-hundred and thirty-one normally voiding children with a single symptomatic UTI were age-matched based on age at diagnosis of UTI at a 1:1 ratio. Chi-square tests and Generalized Estimating Equation analysis, controlling for clinicopathological factors, were performed to compare rates of pathogen-associations with UTI between groups and likelihood of UTI with multi-drug resistant (MDR) organisms. Results: Children in the SB-NB group had a higher rate of non-E. coli UTI compared with controls (64% vs. 41%, p < 0.01), particularly associated with Klebsiella species the SB-NB group had an overall higher infection rate with MDR organisms (21% vs. 10%, p < 0.01) and E. coli isolates, with a trend towards increased rates of antibiotic resistance to aminoglycosides, fluoroquinolones, cephalosporins, extended spectrum β-lactams, and TMP-SMZ. Additionally, patients in the SB-NB group had a 10-fold increase of urosepsis with 57% of events caused by MDR organisms. Conclusions: Children with SB-NB are more likely to have non-E. coli UTI, UTIs with MDR organisms, and urosepsis than the general pediatric population. [Table presented]

KW - Escherichia coli

KW - Multi-drug resistant

KW - Neurogenic bladder

KW - Spina bifida

KW - Urinary tract infection

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