{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:43:14Z","timestamp":1787020994460,"version":"build-2736575974"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trop Med Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The production of extended-spectrum beta-lactamases (ESBLs) among uropathogens, particularly\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp., poses a severe public health concern. This study explored the epidemiology of ESBL-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp. isolated from urine samples obtained at a tertiary care children's hospital in Nepal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study was conducted from August 2016 to February 2017. A total of 745 clean catch urine samples were obtained from pediatric patients under the age of 13 and subjected to semiquantitative culture.\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp. were identified using standard laboratory protocols. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method, and ESBL producers were phenotypically identified using the combined disk method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the bacterial isolates,\n                      <jats:italic>E. coli<\/jats:italic>\n                      predominated, accounting for 139 (81.8%) positive cases. Notably,\n                      <jats:italic>E. coli<\/jats:italic>\n                      showed high susceptibility to nitrofurantoin, with 117 (84.2%) isolates being susceptible. Meanwhile,\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      showed high susceptibility to gentamicin, with 21 (91.3%) isolates being susceptible. Of the 163 isolates of\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp., 62 (38.0%) were identified as multidrug-resistant (MDR), with 42 (25.8%) confirmed as phenotypic ESBL producers. Remarkably, all 41 (100%) ESBL-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates were susceptible to imipenem.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The prevalence of ESBL producers among\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      isolates from pediatric patients underscores the importance of antimicrobial stewardship. Nitrofurantoin and gentamicin emerge as effective empirical treatment choices against these pathogens in children. However, the high rates of multidrug resistance and ESBL production highlight the necessity for routine surveillance, and early detection strategies to manage such infections effectively.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41182-024-00587-3","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T22:02:13Z","timestamp":1709244133000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Phenotypic characterization of ESBL-producing urinary isolates of E. coli and Klebsiella spp. in a tertiary care children's hospital in Nepal"],"prefix":"10.1186","volume":"52","author":[{"given":"Santosh","family":"Pantha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4707-1346","authenticated-orcid":false,"given":"Hiramani","family":"Parajuli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3846-0454","authenticated-orcid":false,"given":"Charu","family":"Arjyal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shovana Thapa","family":"Karki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3221-5642","authenticated-orcid":false,"given":"Dhiraj","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,1]]},"reference":[{"issue":"1","key":"587_CR1","doi-asserted-by":"publisher","first-page":"2","DOI":"10.2174\/1872213X13666181228154940","volume":"13","author":"AKC Leung","year":"2019","unstructured":"Leung AKC, Wong AHC, Leung AAM, Hon KL. 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Official permission from the hospital administration was obtained to process these samples further, adhering to the hospital's protocols. Demographic data (age, sex, hospital ward) were collected from patients, who were coded and randomized during data entry to safeguard patient privacy. Thus, the data set contained no personally identifiable information. All the research activities adhered to the principles outlined in the Declaration of Helsinki and its later amendments, ensuring ethical standards were upheld in medical research. As such, there were no specific ethical issues warranting special attention during the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20"}}