Will E. coli retain its leading position as a causative agent of urinary tract infection in children?

Abstract

Introduction. According to information from various literature sources, Escherichia coli is the most common (80–90%) causative agent of urinary tract infection (UTI) in children, it also significantly exceeds the frequency of occurrence of other bacteria, although there is a tendency to gradually decrease its specific gravity, especially against the background of other pathogens of the intestinal group.Aim. To determine the specific gravity of E. coli as the causative agent of UTI, depending on age against the background of other pathogens.Materials and methods. The study involved 133 children aged 1–17 years with UTI, girls – 107, boys – 26. The bacteriological method determined the pathogen, its sensitivity to standard antibiotics and the ability to produce extended-spectrum beta-lactamases (ESBL). Statistical processing was carried out in the Excel program. In the statistical study of the conjugacy of the signs age and infection, the Kruskal – Wallis criterion was used. Patients are grouped into the following age categories: 1–3, 4–7, 8–11, 12–14 and 15–17 years.Results. The authors of the article provided information that E. coli, although it is the leader, but its share is not as large as is commonly believed and is only 26–29%, while 18% of the total are producers of ESBL. The article shows the distribution of UTI pathogens by age groups of children and calculates the empirical probability of detecting various pathogens at different ages. It is shown that the age group of 8–11 years is most susceptible to mixed infection. According to the structure of mixed infections, these are combinations of pathogens of the intestinal group: E. coli with E. faecalis or E. faecium or with Klebsiella pneumoniae.Conclusions. The authors raised the question of the need in the near future to correct the schemes of empirical antibacterial therapy in connection with the excess of the justified 10–20% resistance of E. coli to cephalosporins of the 3rd generation due to an increase in the frequency of ESBL production.