Work

Clinical impacts and management of urinary tract infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae in children: a narrative review

Year: 2025

Type: review

Abstract: The incidence of pediatric urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) has increased worldwide; however, optimal empirical treatment strategies remain controversial. This review addresses the prevalence, virulence factors, clinical impacts, and antibiotic management of UTIs caused by ESBL-PE in children. The prevalence of ESBL-PE among pediatric UTI isolates exceeds 20% in many regions, including Korea. No significant differences exist in the clinical manifestations between ESBL(+) UTIs and other UTIs. Despite in vitro resistance, third-generation cephalosporins frequently achieve therapeutic success because of their high urinary drug concentrations. Based on the patient's condition and risk factors, an initial empirical antibiotic should be selected, and early de-escalation and carbapenem-sparing strategies are essential to balance treatment efficacy and resistance prevention. Therefore, Korean guidelines for the treatment of pediatric UTIs are required.

Source: Journal of the Korean Society of Pediatric Nephrology

DOI: 10.3339/ckd.25.028

Authors: Jisun Park, Eun Young Joo, Ji-Eun Lee, Su Jin Kim

Institutions: Inha University, Inha University Hospital

Language: English

Topic: Urinary Tract Infections Management

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Inha University