European Journal of Cardiovascular Medicine

Background:  The most frequent infection in young infants and children is urinary tract infection (UTI). They are linked to long-term consequences such as renal scarring and chronic renal failure, for which prompt treatment is required. UTIs are most commonly caused by Enterobacteriaceae, specifically Escherichia coli. Objectives: 1) To analyze the risk factors associated with ESBL positive urinary tract infections in children between 2 months -15 years. 2) To look at the outcome of patients treated for ESBL UTIs over a 3 month follow up period. Material & Methods: Hospital based Prospective Observational study. Study area:  Department of Paediatrics, Government Medical College, Kadapa, Andhra Pradesh. Study consisted of 100 cases and 252 controls. All children between 2 months to 15 yrs age group with positive urine c/s were enrolled. Informed consent was taken. Child’s history, clinical examination and risk factors for urinary tract infection were recorded in the proforma questionnaire. Urine routine and urine culture sensitivity were done for all patients. Complete blood count was recorded if available. Results: ESBL Klebsiella when compared to non ESBL Klebsiella had statistically higher rates of co resistance to Quinolones (p = 0.05), Carbapenems (p = 0.04) and Monobactams (p = 0.01) Out of 3 children with ESBL Enterobacter spp, 3(100%) were resistant to Quinolones and Monobactams. 2(66.6%) ESBL Enterobacter spp were resistant to Trimethoprim Sulfamethoxazole. 1(33.3%) was resistant to both Cefoperazone Sulbactam and Piperacillin Tazobactam. Conclusion: According to our findings, ESBL UTI is frequent in children aged 2 months to 2 years. Males were shown to have a higher prevalence of both ESBL and non-ESBL UTIs. Significant risk factors for ESBL UTI were revealed to be underlying renal issues, recent antibiotic use, recent hospitalization, recent catheterization, previous UTI, and antibiotic prophylaxis.