Rising cases of community-acquired E. coli UTI in children a cause for concern

A recent study has found an increasing prevalence of community-acquired (CA) urinary tract infection (UTI) by emerging spectrum-β-lactamase-producing (ESBL) E. coli in children, with most isolates showing resistance to multiple drugs.

“Antimicrobial resistance and ESBL infections are a rising concern in public health,” the investigators said. “Despite the increasing prevalence of CA-ESBL E. coli UTIs, there is little data on the antibiotic resistance profiles of this bacterial strain in the paediatric population.”

This retrospective study was conducted to review data obtained from the infectious disease database at a paediatric hospital for patients with urine culture that grew ESBL-E. coli from January 2015 to January 2021. The investigators collected demographic information and antimicrobial susceptibility test results for ESBL-E. coli isolates from CA-UTIs. They then reported annual changes in resistance to antimicrobial agents and average annual percent change in ESBL-E. coli UTI presentation over the study period.

Majority of the participants were male (n=77, 57 percent) and multiethnic, with a mean age of 6.9 years. A total of 6,403 urine cultures grew E. coli from January 2015 to January 2021, of which 169 were obtained from 135 children. CA-UTI by ESBL-producing E. coli constituted 2.62 percent of the total E. coli UTIs within the study period. This further rose by an average of 0.51 percent each year, from 0.97 percent in 2015 to 3.54 percent in 2020.

“As CA-ESBL E. coli UTIs are associated with prolonged hospitalization and increased morbidity, our findings highlight the rising trend in paediatric CA-ESBL E. coli UTI,” the investigators said.