J Korean Soc Pediatr Nephrol > Volume 16(1); 2012 > Article
J Korean Soc Pediatr Nephrol 2012;16(1): 38-45. doi: https://doi.org/10.3339/jkspn.2012.16.1.38
발열성 소아 요로감염에서 Extended-Spectrum β-Lactamase 생성 Escherichia coli의 임상적 의의
박철, 김민상, 김미경, 임형은, 유기환, 홍영숙, 이주원
1고려대학교 의과대학 소아과학교실
2고려대학교 의과대학 소아과학교실
3고려대학교 의과대학 소아과학교실
4고려대학교 의과대학 소아과학교실
5고려대학교 의과대학 소아과학교실
6고려대학교 의과대학 소아과학교실
7고려대학교 의과대학 소아과학교실
Clinical Significance of Extended-Spectrum β-Lactamase Producing Escherichia coli in Pediatric Patients with Febrile Urinary Tract Infection
Cheol Park, Min-Sang Kim, Mi-Kyung Kim, Hyung-Eun Yim, Kee-Hwan Yoo, Young-Sook Hong, Joo-Won Lee
1Department of Pediatrics, Korea University
2Department of Pediatrics, Korea University
3Department of Pediatrics, Korea University
4Department of Pediatrics, Korea University
5Department of Pediatrics, Korea University
6Department of Pediatrics, Korea University
7Department of Pediatrics, Korea University
Received: March 8, 2012;  Accepted: April 5, 2012.
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Purpose: The incidence of community-acquired urinary tract infection (UTI) due to extended-spectrum ${beta}$-lactamase producing $Escherichia$ $coli$ (ESBL(+) $E.$ $coli$) has increased worldwide. ESBL causes resistance to various types of the newer ${beta}$-lactam antibiotics, including the expanded spectrum cephalosporins and monobactams. We aimed to investigate the severity of UTI and associated genitourinary malformations in children with febrile UTI caused by ESBL(+) $E.$ $coli$.
Methods: We retrospectively reviewed the medical records of 290 patients diagnosed as febrile UTI caused by $E.$ $coli$ between January 2008 and October 2010 at Korea University Medical center. We classified the patients into two groups with ESBL(+) and ESBL(-) $E.$ $coli$ group according to the sensitivity of urine culture. Fever duration, admission period, white blood cell (WBC) counts and C-reactive protein (CRP) in peripheral blood, the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR) and renal scar were compared between the two groups.
Results : Patients with ESBL(+) $E.$ $coli$ were 32, and those with ESBL(-) $E.$ $coli$ were 258. If we excluded those tested with a sterile urine bag, patients with ESBL(+) $E.$ $coli$ were 22, and those with ESBL(-) $E.$ $coli$ were 212. Whether the results of sterile urine bag tests were included or not, there was no significant difference in all parameters between the two groups statistically.
Conclusion : Our data shows that ESBL(+) $E.$ $coli$ may not be related to the severity of UTI and associated genitourinary malformations.
Key words: Extended-spectrum ${\beta}$-lactamase | Escherichia coli | Urinary tract infection

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