Potential Perinatally Acquired Extended Spectrum ß-Lactamase Escherichia coli Urinary Tract Infection in an Infant.

Autor: Ziegler, Jason, Chapman, Heather, Rueth, Megan, Hays, Annette, Schriever, Christopher, Tsaras, Geoffrey
Předmět:
Zdroj: Journal of Pediatric Pharmacology & Therapeutics; 2020, Vol. 25 Issue 3, p266-269, 4p
Abstrakt: Extended-spectrum ß-lactamases (ESBL) are produced mainly by members of the Enterobacteriaceae family and confer resistance to most ß-lactam antibiotics. Because of limited treatment options, ESBL infections are typically more challenging to treat resulting in poor outcomes, increased complications, and mortality. Because ESBL-producing organisms are primarily seen in critically ill patients, along with those patients having prolonged hospital stays, extensive courses of antimicrobials, and/or use of invasive medical devices (i.e., urinary catheters, central venous lines, or endotracheal tubes), guidelines regarding the management of ESBL-producing organisms in the pediatric population are scant. A review of current recommended treatment options for infections caused by ESBL-producing organisms centers on the use of carbapenems, with some supportive literature regarding the utility/effectiveness of other non-ß-lactam therapy. We present a case report of an 8-month-old female diagnosed with a urinary tract infection due to ESBL-producing Escherichia coli successfully treated with sulfamethoxazole/trimethoprim. Multidrug resistant infections in pediatric patients without risk factors remains an important field of study because these unique infections may pose a problem when choosing an effective empiric antimicrobial therapy. ABBREVIATIONS AAP, American Academy of Pediatrics; CBC, complete blood count; CFU, colony-forming unit; E coli, Escherichia coli; ESBL, extended-spectrum ß-lactamase; IM, intramuscular; MDR, multidrug resistant; UTI, urinary tract infection; WBC, white blood cell. [ABSTRACT FROM AUTHOR]
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