{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:37:32Z","timestamp":1747186652411,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T00:00:00Z","timestamp":1539561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Health and Medical Research Council of Australia","award":["402764","211205"],"award-info":[{"award-number":["402764","211205"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare the spectra of pathogens causing febrile urinary tract infections (UTI) in children, treatment and antimicrobial susceptibility between 2004\u20132006 and 2007\u20132009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>UTI were identified from a cohort study of febrile children younger than 5 years presenting to a large tertiary children's hospital's emergency department with febrile illnesses. We compared pathogenic profiles, antibiotic choices and susceptibilities between 2004\u20132006 and 2007\u20132009 and tested for differences using <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> and Fisher's exact tests. Antibiotic choice was compared with national therapeutic guideline recommendations for UTI in children (oral cotrimoxazole, cephalexin or amoxycillin\u2010clavulanate or intravenous gentamicin plus ampicillin).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 539 (2.71%) confirmed UTI from 19\u2009889 febrile illnesses in 2004\u20132006 and 654 (2.99%) confirmed UTI from 21\u2009846 febrile illnesses in 2007\u20132009. There was no difference in the frequency of the isolated pathogens by period: <jats:italic>Escherichia coli<\/jats:italic> (69.2 vs. 69.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.85), <jats:italic>Proteus mirabilis<\/jats:italic> (7.9 vs. 7.2%, <jats:italic>P<\/jats:italic>\u2009=\u20090.66) and <jats:italic>Klebsiella<\/jats:italic> species (6.2 vs. 4.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.25). National therapeutic guideline recommendations were followed in 277 of 539 (51.4%) versus 318 of 654 (48.6%) (<jats:italic>P<\/jats:italic>\u2009=\u20090.34). Oral antibiotics were given in 20.6 versus 18.9%. There was no difference in extended spectrum beta lactamase (1.5 vs. 1.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.82) or other antibiotic susceptibilities (e.g. <jats:italic>E. coli<\/jats:italic>: cotrimoxazole\u2009=\u200975.9 vs. 75.2%, <jats:italic>P<\/jats:italic>\u2009=\u20090.8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, approximately 3% of febrile illnesses were due to UTI, but we found no change in the spectrum of pathogens or antibiotic susceptibility patterns, including extended\u2010spectrum beta\u2010lactamase, with time. In both time periods, treatment followed therapeutic guidelines approximately half the time, and most pathogens were susceptible to oral antibiotics, but they were infrequently used.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14275","type":"journal-article","created":{"date-parts":[[2018,10,16]],"date-time":"2018-10-16T01:45:27Z","timestamp":1539654327000},"page":"680-689","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Urinary tract infections in febrile children: Changing spectra of pathogenic bacteria and antibiotic susceptibilities?"],"prefix":"10.1111","volume":"55","author":[{"given":"Jus","family":"Rakhra","sequence":"first","affiliation":[{"name":"Department of General Medicine The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Williams","sequence":"additional","affiliation":[{"name":"Screening and Test Evaluation Program, School of Public Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben J","family":"Marais","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Children's Hospital at Westmead  Sydney New South Wales Australia"},{"name":"Marie Bashir Institute for Infectious Diseases and Biosecurity  Sydney New South Wales Australia"},{"name":"Children's Hospital at Westmead Clinical School, University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan C","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Children's Hospital at Westmead  Sydney New South Wales Australia"},{"name":"Screening and Test Evaluation Program, School of Public Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4900-1277","authenticated-orcid":false,"given":"Hasantha","family":"Gunasekera","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Children's Hospital at Westmead  Sydney New South Wales Australia"},{"name":"Children's Hospital at Westmead Clinical School, University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1825"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.2.179"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2006.02.011"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.66.2.232"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0685"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-007-0701-1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2015.03.006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2015.00045"},{"key":"e_1_2_7_10_1","first-page":"125","article-title":"A reflection on bacterial resistance to antimicrobial agents at a major tertiary care center in Lebanon over a decade","volume":"60","author":"Araj GF","year":"2012","journal-title":"J. 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