{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T16:45:58Z","timestamp":1793897158476,"version":"4.8.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T00:00:00Z","timestamp":1476835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study investigated risk factors of childhood urinary tract infection (<jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>) associated with extended\u2010spectrum \u03b2\u2010lactamase (<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>)\u2010producing bacteria (<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>) and evaluated antimicrobial resistance as well as empiric treatment of childhood <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The records of children with positive urine culture between 1 January 2008 and 31 December 2012 were evaluated. Patients with positive urine culture for <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing bacteria were defined as the <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive group, whereas patients of the same gender and similar age with positive urine culture for non\u2010<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing bacteria were defined as the <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010negative group. Each <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive patient was matched with two <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010negative patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive and negative groups consisted of 154 and 308 patients, respectively. Potential risk factors for <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> were identified as presence of underlying disease, clean intermittent catheterization (<jats:styled-content style=\"fixed-case\">CIC<\/jats:styled-content>), hospitalization, use of any antibiotic and history of infection in the last 3 months (<jats:italic>P<\/jats:italic> &lt; 0.05). On logistic regression analysis, <jats:styled-content style=\"fixed-case\">CIC<\/jats:styled-content>, hospitalization and history of infection in the last 3 months were identified as independent risk factors. In the present study, 324 of 462 patients had empiric therapy. Empiric therapy was inappropriate in 90.3% of the <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive group and in 4.5% of the <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010negative group. Resistance to nitrofurantoin was similar between groups (5.1% vs 1.2%, <jats:italic>P<\/jats:italic> = 0.072); resistance to amikacin was low in the <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive group (2.6%) and there was no resistance in the <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010negative group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clean intermittent catheterization, hospitalization and history of infection in the last 3 months should be considered as risk factors for <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>. The combination of ampicillin plus amikacin should be taken into consideration for empiric therapy in patients with acute pyelonephritis who have the risk factors for <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010positive <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>. Nitrofurantoin seems to be a logical choice for the empiric therapy of cystitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13112","type":"journal-article","created":{"date-parts":[[2016,8,8]],"date-time":"2016-08-08T18:16:33Z","timestamp":1470680193000},"page":"176-180","source":"Crossref","is-referenced-by-count":31,"title":["Childhood urinary tract infection caused by extended\u2010spectrum \u03b2\u2010lactamase\u2010producing bacteria: Risk factors and empiric therapy"],"prefix":"10.1111","volume":"59","author":[{"given":"Nihal","family":"Uyar Aksu","sequence":"first","affiliation":[{"name":"Department of Pediatrics Kocaeli University Faculty of Medicine Kocaeli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelal","family":"Ekinci","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kocaeli University Faculty of Medicine Kocaeli Turkey"},{"name":"Division of Pediatric Nephrology Kocaeli University Faculty of Medicine Kocaeli 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