Vol.65 No.6 November 2017
Prevalence of extended-spectrum β-lactamase ESBL-producing bacteria in the pediatric setting
1)Department of Pediatrics, The Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo, Japan
2)Central Clinical Laboratory, The Jikei University Katsushika Medical Center
3)Department of Infectious Disease and Infection Control, The Jikei University Katsushika Medical Center
4)Department of Urology, The Jikei University Katsushika Medical Center
Abstract
Infection caused by extended-spectrum β-lactamase (ESBL)-producing bacteria has been increasing and spreading to the community in Japan. Recently, reports on urinary tract infection caused by ESBL-producing bacteria have also increased in the pediatric population, but epidemiological information is not sufficient. We investigated the prevalence of ESBL-producing bacteria in the Department of Pediatrics in the Jikei University Katsushika Medical Center from January 2012 to December 2016. Eighty-three samples of ESBL-producing strains (81 patients) were isolated from specimens submitted for identification of bacteria in this 5-year period. The increase in the annual trend after 2015 was remarkable. Escherichia coli (E. coli) (92.7%) was the most common isolate in our hospital. The detection rates of ESBL-producing strains in fecal and urine cultured samples were 3.4% (68/2,001) and 0.9% (10/1,154), respectively. The age distribution of 81 patients with ESBL-producing bacteria detected was 3 to 21 years old (median age: 2 years 4 months), with the majority comprising young children under 6 years. In 6 infection cases with ESBL-producing bacteria, 5 cases were upper urinary tract infections. One case was bacteremia complicated with appendicitis, all of them were caused by E. coli. Upper urinary tract infection with E. coli experienced in this study period comprised 44 cases, and the proportion of ESBL-producing E. coli was 11.4% (5/44). Our results suggest that ESBL-producing bacteria can be a causative bacterium for infectious diseases even in the pediatric population and exist in the intestinal tract in young children. Even for children in the outpatient environment with no medical-related risks, it is important to use appropriate antibiotics against ESBL-producing bacteria and make effort to prevent nosocomial infection through taking to standard and contact precautions in the pediatric care setting.
Key word
extended-spectrum β-lactamase（ESBL）, Escherichia coli, urinary tract infection, child, carrier
Received
September 12, 2017
Accepted
September 25, 2017
Jpn. J. Chemother. 65 (6): 812-816, 2017
