Prevalence of ESBL producing Enterobacteriaceae in paediatric urinary tract infections: A systematic review and meta analysis.
OBJECTIVES We aimed to evaluate the prevalence of paediatric urinary tract infections (UTIs) caused by extended spectrum beta lactamase producing Enterobacteriaceae (ESBL PE) identify predisposing factors and examine their effect on the length of hospital stay (LOS) METHODS For this systematic review and meta analysis, we searched the PubMed and EMBASE databases for studies that provide data on the rate of ESBL PE among paediatric UTIs. RESULTS Out of 1828 non duplicate citations, 16 studies reporting a total of 7374 cases of UTI were included. The prevalence of ESBL PE was 14% (95%CI 8, 21) Vesicoureteral reflux (VUR) [OR 2.79, (95%CI 1.39, 5.58) history of UTI [OR 2.89 (95%CI 1.78, 4.68) and recent antibiotic use [OR 3.92, (95%CI 1.76, 8.7) were identified as risk factors. The LOS was significantly longer among children infected with ESBL PE, compared to those infected with other uropathogens. [SMD 0.88, (95%CI 0.40, 1.35) CONCLUSIONS In the paediatric population, 1 out of 7 UTIs are caused by ESBL PE. Patients with VUR, previous UTI or recent antibiotic use constitute a high risk group and these pathogens are associated with increased LOS. The significant incidence of ESBL PE in this population should be taken into consideration in the development of empiric treatment protocols and antibiotic stewardship programmes, especially in high prevalence areas.
The Journal of infection