Selma Oktay Ergin, Feyza Mediha Yildiz
Ankara City Hospital Medical Journal - 2025;4(3):93-100
Introductıon: Extended-spectrum beta-lactamase (ESBL)-producing Esche -richia (E.) coli has become an increasing concern in pediatric community-a -cquired urinary tract infections (UTIs). The primary aim of this study is to investigate and identify the clinical, demographic, and medical history-re -lated risk factors associated with ESBL-producing E. coli strains isolated from urine cultures of pediatric patients diagnosed with community-acqu -ired UTIs. Methods : : We retrospectively reviewed 100 pediatric patients with ESBL-positive E. coli UTIs hospitalized between 2008-2012, all of whom received meropenem therapy. Risk factors, clinical manifestations, urine collection methods, comorbidities, and prior antibiotic exposure were col -lected. Results :ESBL-positive E. coli UTIs were more frequent in boys during the neonatal period but became predominant in girls thereafter, with the highest prevalence under two years of age. Clinical manifestations vary with age, ranging from nonspecific symptoms such as fever and vomiting in infants to typical complaints like abdominal pain and dysuria in older children. E. coli was identified as the leading pathogen, while high resistance rates to commonly used antibiotics (ampicillin, amoxicillin/clavulanate, TMP-SMX) were observed. Carbapenems remained the most effective agents, though their use should be reserved due to cost and hospitalization require -ments. Underlying urinary tract abnormalities, vesicoureteral reflux, recur -rent infections, and recent antibiotic exposure were major risk factors for ESBL (+) UTIs. Conclusion: Our results highlight the clinical significance of ESBL-produ -cing E. coli in pediatric UTIs. Early recognition of risk factors, careful di -agnostic evaluation, and rational antibiotic selection are crucial for optimal management.
