Urinary Tract Infections among Febrile Infants in Qatar: Extended-Spectrum-Beta-Lactamase (ESBL)-Producing Versus Non-ESBL Organisms
Abstract
:1. Introduction
2. Results
3. Discussion
4. Methods
4.1. Study Design, Setting and Participants
4.2. Inclusion and Exclusion Criteria
4.3. Data Collection and Study Variables
4.4. Ethical Approval
4.5. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Total | ESBL | Non-ESBL Urinary Organisms | p-Value † |
---|---|---|---|---|
(n = 459) | (n = 133) | (n = 326) | ||
n (%) | n (%) | n (%) | ||
Gender | 0.888 | |||
Male | 161 (35) | 46 (34.6) | 115 (35.3) | |
Female | 298 (65) | 87 (65.4) | 211 (64.7) | |
Ethnicity | 0.257 | |||
Non-Qatari | 379 (82.6) | 114 (85.7) | 265 (81.3) | |
Qatari | 80 (17.4) | 19 (14.3) | 61 (18.7) | |
Age Group | 0.184 | |||
>60 days | 403 (87.8) | 121 (91) | 282 (86.5) | |
≤60 days | 56 (12.2) | 12 (9) | 44 (13.5) | |
Gestational Age | 0.208 | |||
≥37 weeks | 321 (87.5) | 80 (82.5) | 241 (89.3) | |
32–36 weeks | 39 (10.6) | 14 (14.4) | 25 (9.3) | |
≤31 weeks | 7 (1.9) | 3 (3.1) | 4 (1.5) | |
Male circumcision | 0.857 | |||
Not circumcised | 69 (68.3) | 14 (70) | 55 (67.9) | |
Circumcised | 32 (31.7) | 6 (30) | 26 (32.1) |
Urine Organism | ESBL | Non-ESBL Urinary Organisms | ||
---|---|---|---|---|
n = 133 | % | n = 326 | % | |
Escherichia coli | 106 | 79.7 | 187 | 57.2 |
Klebsiella pneumoniae | 13 | 9.8 | 61 | 18.7 |
Enterococcus faecalis | - | - | 28 | 8.6 |
Proteus mirabilis | 0 | 0 | 10 | 3.1 |
Citrobacter koseri | 0 | 0 | 9 | 2.8 |
Pseudomonas aeruginosa | 0 | 0 | 9 | 2.8 |
Streptococcus agalactiae | - | - | 8 | 2.5 |
Klebsiella oxytoca | 0 | 0 | 5 | 1.5 |
Enterobacter cloacae | 4 | 3 | 1 | 0.3 |
Citrobacter freundii | 3 | 2.3 | 0 | 0 |
Staphylococcus aureus | - | - | 3 | 0.9 |
Serratia marcescens | 1 | 0.8 | 2 | 0.6 |
Citrobacter amalonaticus | 1 | 0.8 | 0 | 0 |
Enterobacter gergoviae | 1 | 0.8 | 0 | 0 |
Enterococcus raffinosus | 0 | 0 | 1 | 0.3 |
Klebsiella aerogenes | 1 | 0.8 | 0 | 0 |
Klebsiella ozaenae | 0 | 0 | 1 | 0.3 |
Morganella morganii | 1 | 0.8 | 1 | 0.3 |
Proteus hauseri | 0 | 0 | 1 | 0.3 |
Streptococcus gallolyticus | - | - | 1 | 0.3 |
ESBL (n = 133) | Non-ESBL (n = 326) | p-Value † | |||
---|---|---|---|---|---|
Laboratory Parameters and Clinical History | Median | IQR | Median | IQR | |
WBCs | 13.3 | 8.3–18.3 | 12 | 8.6–16.8 | 0.251 |
ANCs | 5.8 | 2.6–9.3 | 4.9 | 2.8–8.1 | 0.434 |
Platelets | 407 | 303–476 | 373 | 301–454 | 0.205 |
CRP (mg/L) | 29 | 6.3–55 | 17.4 | 5–52 | 0.446 |
Na level | 138 | 136–139 | 137 | 136–138 | 0.314 |
BUN level | 2.7 | 1.9–3.7 | 3 | 2.1–3.9 | 0.124 |
Creatinine level | 20 | 17–23 | 22 | 19–26 | <0.001 |
n | % | n | % | p-value | |
Urine WBCs (>9) | 105 | 80.8% | 209 | 64.9% | <0.001 |
UA leukocytes (≥trace) | 71 | 54.2% | 135 | 42.5% | 0.023 |
UA nitrites | 51 | 38.9% | 77 | 24.2% | 0.002 |
NICU admission | 31 | 29.2% | 61 | 21.9% | 0.129 |
Previous hospitalization | 12 | 10.2% | 26 | 8.4% | 0.576 |
Previous surgeries | 0 | 0% | 2 | 0.6% | NA |
Presence of renal/urogenital anomalies/diseases | 10 | 9.4% | 17 | 6.4% | 0.303 |
Presence of urological anomalies using VCUG | 3 | 5.7% | 6 | 5.1% | 0.572 |
Abnormal US result | 11 | 12% | 24 | 12.8% | 0.847 |
Circumcised | 6 | 30% | 26 | 32.1% | 0.857 |
Previous positive urine culture | 10 | 8.3% | 26 | 9.8% | 0.637 |
Abnormality | ESBL | Non-ESBL Urinary Organisms |
---|---|---|
n (%) | n (%) | |
Hydronephrosis | 10 (10.9) | 19 (10.1) |
Dysplastic kidney | 0 (0) | 1 (0.5) |
Horseshoe kidney | 0 (0) | 1 (0.5) |
Ectopic kidney | 0 (0) | 2 (1.1) |
Duplex collecting system | 1 (1.1) | 1 (0.5) |
Organism | n | Route (%) | † (IV) Antibiotic (%) | (Oral) | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Oral n (%) | † IV n (%) | Ceftriaxone | Gentamicin | Amoxicillin | Ampicillin | Tazocin *** | Cefepime | Cefotaxime | Ertapenem | Amikacin | Meropenem | Cefixime | Amox/Clav * | Cefuroxime | Nitrofurantoin | TMP–SMX ** | Cefdinir | |||
Non-ESBL | Escherichia coli | 187 | 132 (70.6) | 55 (29.4) | 21 | 3.8 | 0.5 | 0.5 | 2.2 | 51.1 | 14 | 3.2 | 2.2 | 1.6 | ||||||
Klebsiella pneumoniae | 61 | 40 (65.6) | 21 (34.4) | 20 | 3.3 | 1.7 | 5 | 1.7 | 41.7 | 20 | 5 | 1.7 | ||||||||
Enterococcus faecalis | 28 | 17 (60.7) | 11 (39.3) | 23.1 | 7.7 | 7.7 | 30.8 | 19.2 | 11.5 | |||||||||||
Proteus mirabilis | 10 | 8 (80) | 2 (20) | 10 | 30 | 40 | 20 | |||||||||||||
Citrobacter koseri | 9 | 6 (66.6) | 3 (33.3) | 33.3 | 55.6 | 11.1 | ||||||||||||||
Pseudomonas aeruginosa | 9 | 1 (11.1) | 8 (88.9) | 11.1 | 66.7 | 11.1 | 11.1 | |||||||||||||
Streptococcus agalactiae | 8 | 1 (12.5) | 7 (87) | 42.9 | 14.3 | 14.3 | 14.3 | 14.3 | ||||||||||||
Klebsiella oxytoca | 5 | 2 (40) | 3 (60) | 60 | 40 | |||||||||||||||
Staphylococcus aureus | 3 | 1 (33.3) | 2 (66.7) | 66.7 | 33.3 | |||||||||||||||
Serratia marcescens | 2 | 1 (50) | 1 (50) | 50 | 50 | |||||||||||||||
Enterobacter cloacae | 1 | 1 (100) | 0 (0) | 100 | ||||||||||||||||
Enterococcus raffinosus | 1 | 1 (100) | 0 (0) | 100 | ||||||||||||||||
Klebsiella ozaenae | 1 | 1 (100) | 0 (0) | 100 | ||||||||||||||||
Morganella morganii | 1 | 1 (100) | 0 (0) | 100 | ||||||||||||||||
Proteus hauseri | 1 | 1 (100) | 0(0) | 100 | ||||||||||||||||
Streptococcus gallolyticus | 1 | 0 (0) | 1(100) | 100 | ||||||||||||||||
Total | 328 | 214 (65.6) | 114 (34.4) | 21.9 | 4.9 | 0.9 | 0.9 | 0.3 | 0.6 | 2.5 | 0.3 | 45.1 | 15.4 | 3.4 | 2.2 | 1.5 | ||||
ESBL | Escherichia coli | 106 | 45 (42.5) | 61 (57.5) | 8.6 | 36.2 | 1 | 1.9 | 6.7 | 2.9 | 23.8 | 1 | 13.3 | 4.8 | ||||||
Klebsiella pneumoniae | 13 | 5 (38.5) | 8 (61.5) | 15.4 | 38.5 | 7.7 | 7.7 | 23.1 | 7.7 | |||||||||||
Enterobacter cloacae | 4 | 2 (50) | 2 (50) | 50 | 25 | 25 | ||||||||||||||
Citrobacter freundii | 3 | 2 (66.7) | 1 (33.3) | 33.3 | 33.3 | 33.3 | ||||||||||||||
Serratia marcescens | 1 | 0 (0) | 1 (100) | 100 | ||||||||||||||||
Citrobacter amalonaticus | 1 | 0 (0) | 1 (100) | 100 | ||||||||||||||||
Enterobacter gergoviae | 1 | 0 (0) | 1 (100) | 100 | ||||||||||||||||
Klebsiella aerogenes | 1 | 0 (0) | 1 (100) | 100 | ||||||||||||||||
Morganella morganii | 1 | 1 (100) | 0 (0) | 100 | ||||||||||||||||
Total | 131 | 55 (43.1) | 76 (56.9) | 9.1 | 36.4 | 0.8 | 0.8 | 1.5 | 6.1 | 3 | 22.7 | 0.8 | 11.4 | 6.8 | 0.8 |
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Qusad, M.; Elhalabi, I.; Ali, S.; Siddiq, K.; Loay, L.; Aloteiby, A.; Al Ansari, G.; Moustafa, B.; Olukade, T.; Al Amri, M.; et al. Urinary Tract Infections among Febrile Infants in Qatar: Extended-Spectrum-Beta-Lactamase (ESBL)-Producing Versus Non-ESBL Organisms. Antibiotics 2024, 13, 547. https://doi.org/10.3390/antibiotics13060547
Qusad M, Elhalabi I, Ali S, Siddiq K, Loay L, Aloteiby A, Al Ansari G, Moustafa B, Olukade T, Al Amri M, et al. Urinary Tract Infections among Febrile Infants in Qatar: Extended-Spectrum-Beta-Lactamase (ESBL)-Producing Versus Non-ESBL Organisms. Antibiotics. 2024; 13(6):547. https://doi.org/10.3390/antibiotics13060547
Chicago/Turabian StyleQusad, Mohammad, Ihsan Elhalabi, Samer Ali, Khaled Siddiq, Lujain Loay, Abdallah Aloteiby, Ghada Al Ansari, Bassem Moustafa, Tawa Olukade, Mohammed Al Amri, and et al. 2024. "Urinary Tract Infections among Febrile Infants in Qatar: Extended-Spectrum-Beta-Lactamase (ESBL)-Producing Versus Non-ESBL Organisms" Antibiotics 13, no. 6: 547. https://doi.org/10.3390/antibiotics13060547
APA StyleQusad, M., Elhalabi, I., Ali, S., Siddiq, K., Loay, L., Aloteiby, A., Al Ansari, G., Moustafa, B., Olukade, T., Al Amri, M., Soliman, A., & Khalil, A. (2024). Urinary Tract Infections among Febrile Infants in Qatar: Extended-Spectrum-Beta-Lactamase (ESBL)-Producing Versus Non-ESBL Organisms. Antibiotics, 13(6), 547. https://doi.org/10.3390/antibiotics13060547