Community-acquired enterococcal urinary tract infections in hospitalized children

Nir Marcus, Shai Ashkenazi, Zmira Samra, Avner Herm Cohen, Gilat Livni

Research output: Contribution to journalArticlepeer-review

Abstract

The objectives of this study were to characterize community-acquired (CA) enterococcal urinary tract infections (UTIs) in a tertiary pediatric center and to determine risk factors for their occurrence, their association with renal abnormalities, their antibiotic susceptibility profile, and the appropriateness of the empiric antibiotic treatment, in comparison to those of Gram-negative UTIs. In a 5-year prospective clinical and laboratory study, we found that enterococcal UTIs caused 6.2% (22/355) of culture-proven CA UTIs. Compared with Gram-negative UTI, enterococcal UTI was associated with male predominance, higher rates of underlying urinary abnormalities (70 vs. 43.7%; p∈=∈0.03) and inappropriate empiric antibiotic therapy (22 vs. 5.6%; p∈=∈0.02), and mainly vesicoureteral reflux (53% of cases). This study highlights the importance of early detection of CA enterococcal UTIs because of their association with underlying urinary abnormalities and a high rate of inappropriate empiric antibiotic therapy. Renal imaging is recommended for children with enterococcal UTIs; Gram stain is suggested in selected cases to detect Gram-positive cocci for early diagnosis of enterococcal UTIs and initiation of appropriate antibiotics.

Original languageEnglish
Pages (from-to)109-114
Number of pages6
JournalPediatric Nephrology
Volume27
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Keywords

  • Antimicrobial resistance
  • Children
  • Community-acquired
  • Empiric antibiotic therapy
  • Enterococcus spp.
  • Uropathogens
  • Vesicoureteral reflux

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