RT Journal Article
T1 Treatment and Outcomes of Children With Febrile Urinary Tract Infection Due to Extended Spectrum Beta-lactamase-producing Bacteria in Europe: TOO CUTE Study.
A1 Vazouras, Konstantinos
A1 Hsia, Yingfen
A1 Folgori, Laura
A1 Bielicki, Julia
A1 Aguadisch, Elise
A1 Bamford, Alasdair
A1 Brett, Ana
A1 Caseris, Marion
A1 Cerkauskiene, Rimante
A1 De Luca, Maia
A1 Iosifidis, Elias
A1 Kopsidas, John
A1 Manzanares, Ángela
A1 Planche, Tim
A1 Riordan, Andrew
A1 Srovin, Tina Plankar
A1 Valdivielso Martínez, Ana Isabel
A1 Vergadi, Eleni
A1 Sharland, Mike
A1 Basmaci, Romain
AB The prevalence of extended-spectrum beta-lactamase producing Εnterobacteriaceae (ESBL-PE) is increasing globally. ESBL-PE are an important cause of urinary tract infections (UTIs) in children. We aimed to characterize the clinical presentation, treatment and outcomes of childhood UTI caused by ESBL-PE in Europe. Multicenter retrospective cohort study. Children 0 to 18 years of age with fever, positive urinalysis and positive urine culture for an ESBL-PE uropathogen, seen in a participating hospital from January 2016 to July 2017, were included. Primary outcome measure: day of defervescence was compared between (1) initial microbiologically effective treatment (IET) versus initial microbiologically ineffective treatment (IIT) and (2) single initial antibiotic treatment versus combined initial antibiotic treatment. Clinical and microbiologic failure of initial treatment. We included 142 children from 14 hospitals in 8 countries. Sixty-one children had IET and 77 IIT. There was no statistical difference in time to defervescence for effective/ineffective groups (P = 0.722) and single/combination therapy groups (P = 0.574). Two of 59 (3.4%) and 4/66 (6.1%) patients exhibited clinical failure during treatment (P = 0.683) when receiving IET or IIT, respectively. Eight of 51 (15.7%) receiving IET and 6/58 (10.3%) receiving IIT patients (P = 0.568) had recurring symptoms/signs suggestive of a UTI. Recurrence of a UTI occurred 15.5 days (interquartile range, 9.0-19.0) after the end of treatment. Time to defervescence and clinical failure did not differ between IET/IIT groups. Non-carbapenem beta-lactam antibiotics may be used for the empiric treatment of ESBL febrile UTIs, until susceptibility testing results become available.
YR 2020
FD 2020
LK http://hdl.handle.net/10668/16278
UL http://hdl.handle.net/10668/16278
LA en
DS RISalud
RD Apr 10, 2025