Raman G, et al. - In this case–control study, the physicians analyzed the risk factors for multiresistant Escherichia coli urinary tract infections (UTIs) in children. It was suggested that clinicians should be careful in the use of antibiotics in treatment and prophylaxis of UTIs. Amoxicillin-clavulanic acid appeared to be an appropriate empiric antibiotic option, in children with UTI and recent antibiotic exposure.

Methods

• This study consisted of all reported urinary isolates from a children’s hospital collected between January 2010 and June 2013. 
• Patients who had multiresistant E. coli UTIs were identified.
• There medical records were reviewed. 
• Patient-specific clinical and demographic factors were compared with age-matched and gender-matched controls with non-multiresistant E. coli UTIs. 
• To evaluate significant risk factors for multiresistant organism E.coli UTIs, the univariable and multivariable statistical analysis were conducted.

Results

•  There were 2692 positive urine cultures, 1676 (62.3%) from 1169 patients were E. coli.
• Multiresistant E. coli was isolated from 139 (8.3% of all E. coli) cultures in 99 patients. 
• 13 incomplete medical records were excluded.
• This study included 86 patients, matched with 86 controls. 
• In multivariable regression, the only significant risk factor was antibiotic use in the previous month (adjusted OR 3.0, 95% CI 1.4 to 6.2), but not previous hospital admission (adjusted OR 1.4, 95% CI 0.6 to 2.9), being an inpatient at the time of diagnosis (adjusted OR 2.4, 95% CI 0.8 to 7.4) and previous instrumentation (adjusted OR 1.0, 95% CI 0.4 to 2.4).