Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0519030 (Klebsiella)
 21,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of the study was to investigate the management of pyelonephritis in a large Italian pediatric population. A total of 1,333 patients (36% male) were considered. Escherichia coli was the most frequently isolated agent (89.9%), followed by Proteus mirabilis (3.6%) and Klebsiella oxytoca (2.1%). 27% of microorganisms were resistant to amoxicillin, 4% to amoxicillin/clavulanic acid, 11% to trimethoprim-sulfamethoxazole, 2.4% to gentamicin and less than 2% to ceftazidime. Despite this resistance pattern showing that oral antibiotics, such as amoxicillin/clavulanic acid, are effective in vitro as well as parenteral antimicrobials, a parenteral antibiotic was given initially to 756 (57.2%) children. A prophylactic regimen was started in 922 patients with a rate of reinfection during prophylaxis of 9.5%; a higher rate of reinfection was observed in patients with reflux (25%) compared to children without reflux (3%) (p < 0.0001). Vesicoureteral reflux was demonstrated in 30% of patients. The number of renal abnormalities detected by DMSA in patients with and without reflux was significantly different (p < 0.001). CRP was higher in patients with scars (p < 0.02). In conclusion, pyelonephritis represents a common disease with about 2,500 days of hospitalization per year in the Veneto Region where there is a pediatric population of about 800,000 under 15 years of age. The results of antimicrobial in vitro tests indicate that amoxillicin/clavulanic acid could represent the antibiotic of choice. The high frequency of malformations, observed even in children between 6 and 12 years of age, may suggest the need of an imaging study including DMSA scan and VCUG in all age groups.
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PMID:Retrospective study of children with acute pyelonephritis. Evaluation of bacterial etiology, antimicrobial susceptibility, drug management and imaging studies. 1174 99

Extended-spectrum beta-lactamase (ESBL)-producing pathogens are emerging as a cause of urinary tract infections (UTI) worldwide. In this matched-case control study, clinical characteristics and associated risk factors for ESBL UTI were evaluated. In a total of 463 positive urine cultures, 48 (10.4%) (from 39 patients, 23 boys) were phenotypically ESBL-producing bacteria. The most frequently isolated microorganism was , followed by Klebsiella spp. and Enterobacter cloacae. Children with ESBL UTI (n=39) were on prophylaxis more (21% vs. 6%, p=0.01), had higher rates of urinary tract anomalies (36% vs. 10%, p=0.0007), presented abnormal 99m Tcdimercaptosuccinic acid (DMSA) findings (i.e. scars) (23% vs. 4%, p=0.001), and had longer hospitalization (9.8 vs. 7.4 days, p=0.004) compared to those with non-ESBL UTI (n=117). The recognition of risk factors for UTI caused by ESBL bacteria in children may aid in the identification of high-risk cases and may enable proper management of these patients.
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PMID:Urinary tract infections caused by extended-spectrum betalactamase-producing bacteria in children: a matched casecontrol study. 2457 73