Trends and risk factors of extended-spectrum beta-lactamase urinary tract infection in Chinese children: a nomogram is built and urologist should act in time

作者全名："Lu, Jiandong; Wang, Lin; Wei, Yi; Wu, Shengde; Wei, Guanghui"

作者地址："[Lu, Jiandong; Wang, Lin; Wei, Yi; Wu, Shengde; Wei, Guanghui] Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders,Dept Uro, Minist Educ,Key Lab Child Dev & Disorders,Chongqi, Chongqing, Peoples R China"

通信作者："Wei, Y (通讯作者)，Room 806,Kejiao Bldg,6 Bldg,136,2nd Zhongshan Rd, Chongqing 400014, Peoples R China."

来源：TRANSLATIONAL PEDIATRICS

ESI学科分类：　

WOS号：WOS:000779426900001

JCR分区：Q2

影响因子：2

年份：2022

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Urinary tract infection (UTI); extended-spectrum beta-lactamase producing bacteria (ESBL-producing bacteria); urological abnormalities; neurological disorder; risk factor

摘要："Background: To investigate the etiological characteristics and risk factors of extended-spectrum betalactamase (ESBL) urinary tract infection (UTI) and construct a corresponding nomogram to predict the probability of ESBL((+)) UTI. Methods: We retrospectively reviewed the records among patients experiencing UTI events in Chongqing Medical University Affiliated Children's Hospital from 1994 and 2019. Results: A total of 854 patients with UTI were evaluated and ESBL-producing bacteria increased significantly. Significant potential risk factors of ESBL-UTI were congenital urological abnormalities, vesicoureteral reflux, neurologic disorder, age <12 months, fever and previous use of antibiotics. On logistic regression analysis, neurological disorder (OR =8, 95% CI: 1.845-34.695) and antibiotics administration in the last 3 months (OR =4.764, 95% CI: 3.114-7.289) were identified as an independent significant risk factor for ESBL-UTI. The nomogram generated was well calibrated for all predictions of ESBL+ probability, and the accuracy of the model nomogram measured by Harrell's C statistic (C-index) was 0.741. Conclusions: The current situation of multiple bacterial antibiotic resistance has become a worrisome issue in UTI and early identification of ESBL production is important in terms of appropriate treatment and effective infection control. We may choose broad-spectrum antibiotics as empirical antibiotics for UTI among children with neurological disease and used antibiotic in the last three months."

基金机构：National Natural Science Foundation of China [81571425]

基金资助正文：This work was supported by the National Natural Science Foundation of China (No. 81571425) .