{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T14:27:57Z","timestamp":1768919277423,"version":"3.49.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"internal funding"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In some countries, third-generation cephalosporins (3GCs) serve as first-line therapy in children with urinary tract infections (UTIs). However, their use may contribute to the emergence of antibiotic resistance, notably among Gram-negative bacteria (GNB). Integrons are bacterial genetic elements involved in antibiotic resistance in GNB. Their absence is associated with &amp;gt;97% susceptibility to trimethoprim\/sulfamethoxazole in adults infected with GNB. The objective of this study was to examine the value of integron detection directly from urine samples as a predictive marker of resistance to trimethoprim\/sulfamethoxazole in children with GNB-related UTIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Children admitted to the Limoges University Hospital\u2019s paediatric emergency department between February 2018 and March 2019 with a suspicion of UTI were eligible for the study. Only confirmed cases presenting a positive urine culture with unique GNB were retained for further study analyses. Integrons were detected directly from urines using real-time PCR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The data of 72 patients were analysed and integrons were detected in 15 urine samples. The negative predictive value of integron detection for resistance to trimethoprim\/sulfamethoxazole was 100% as all of the GNB (all were Enterobacterales) isolated from patients with no integrons detected in their urine samples were susceptible to trimethoprim\/sulfamethoxazole.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The detection of integrons in cases of paediatric patients with suspected UTI could help limit 3GC empirical use and empower an empirical first-line strategy better tailored to the needs of each patient.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkab431","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T20:14:35Z","timestamp":1636488875000},"page":"767-770","source":"Crossref","is-referenced-by-count":3,"title":["Integron detection for prediction of trimethoprim\/sulfamethoxazole susceptibility in children with Enterobacterales urinary tract infections"],"prefix":"10.1093","volume":"77","author":[{"given":"Peter","family":"Elias","sequence":"first","affiliation":[{"name":"Service de P\u00e9diatrie, H\u00f4pital M\u00e8re Enfant, CHU Limoges, 8 Ave D Larrey, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-9206","authenticated-orcid":false,"given":"Olivier","family":"Barraud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, 2 Ave M Luther King, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chahrazed","family":"El Hamel","sequence":"additional","affiliation":[{"name":"Service de P\u00e9diatrie, H\u00f4pital M\u00e8re Enfant, CHU Limoges, 8 Ave D Larrey, Limoges, France"},{"name":"CB-HME, H\u00f4pital M\u00e8re Enfant, CHU Limoges, 8 Ave D Larrey, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delphine","family":"Chainier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, 2 Ave M Luther King, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aymeric","family":"Dallochio","sequence":"additional","affiliation":[{"name":"Service de P\u00e9diatrie, H\u00f4pital M\u00e8re Enfant, CHU Limoges, 8 Ave D Larrey, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Gr\u00e9laud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, 2 Ave M Luther King, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-C\u00e9cile","family":"Ploy","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, 2 Ave M Luther King, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Guigonis","sequence":"additional","affiliation":[{"name":"Service de P\u00e9diatrie, H\u00f4pital M\u00e8re Enfant, CHU Limoges, 8 Ave D Larrey, Limoges, France"},{"name":"CB-HME, H\u00f4pital M\u00e8re Enfant, CHU Limoges, 8 Ave D Larrey, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabien","family":"Garnier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, 2 Ave M Luther King, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,23]]},"reference":[{"key":"2022022312584695400_dkab431-B1","doi-asserted-by":"crossref","first-page":"246.e1","DOI":"10.1016\/j.jpurol.2014.10.005","article-title":"Incidence, admission rates, and economic burden of pediatric emergency department visits for urinary tract infection: data from the nationwide emergency department sample, 2006 to 2011","volume":"11","author":"Sood","year":"2015","journal-title":"J Pediatr Urol"},{"key":"2022022312584695400_dkab431-B2","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.arcped.2015.03.016","article-title":"Prise en charge des infections urinaires de l\u2019enfant. 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