{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:42:22Z","timestamp":1760143342985,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Bacteriuria in paediatric oncology patients have not been well studied. This retrospective study analysed clinical features, distribution and antimicrobial susceptibility of bacterial pathogens cultured from urine in paediatric oncology patients over a 4-year period (2019\u20132022). A total of 143 episodes of bacteriuria were documented in 74 patients. Neutropenia was present in 17.5% (25\/143), symptoms in 25.9% (37\/143) and urinary catheter in 7.0% (10\/143) episodes. Symptomatic bacteriuria episodes were statistically significantly more frequent in patients with neutropenia (p = 0.0232). The most common bacterial pathogens were Escherichia coli (n = 49; 32.2%), Klebsiella spp. (n = 34; 22.4%), Pseudomonas aeruginosa (n = 22; 14.5%) and Enterococcus spp. (n = 21; 13.8%). Extended-spectrum \u03b2-lactamases-producing (ESBL) Enterobacterales were found in 11 episodes (11\/143; 7.7%) with the highest proportion among Klebsiella pneumoniae isolates (n = 7\/34; 20.6%). No carbapenem-resistant Enterobacterales, multidrug-resistant P. aeruginosa or vancomycin-resistant Enterococcus spp. were found. The most important novelties are demonstrating P. aeruginosa as one of the prominent bacteriuria pathogens in this patient population, presence of ESBL isolates and carbapenem-resistant P. aeruginosa later during hospitalization highlights the need for appropriate antimicrobial treatment. However, because of the small number of symptomatic patients, further studies are needed to clarify the importance of including urine culture in the diagnostic process in patients with febrile neutropenia.<\/jats:p>","DOI":"10.3390\/antibiotics13020118","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T03:59:42Z","timestamp":1706155182000},"page":"118","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bacteriuria in Paediatric Oncology Patients: Clinical Features, Distribution and Antimicrobial Susceptibility of Bacterial Pathogens at University Hospital Centre Zagreb, Croatia over a 4-Year Period"],"prefix":"10.3390","volume":"13","author":[{"given":"Nina","family":"Predavec","sequence":"first","affiliation":[{"name":"Department of Clinical Microbiology, Infection Prevention and Control, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Per\u010dini\u0107","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Infection Prevention and Control, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoran","family":"Herljevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Infection Prevention and Control, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violeta","family":"Rezo Vranje\u0161","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Infection Prevention and Control, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Pavlovi\u0107","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zrinko","family":"\u0160alek","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0895-5691","authenticated-orcid":false,"given":"Tomislav","family":"Kuli\u0161","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1909-118X","authenticated-orcid":false,"given":"Ernest","family":"Bili\u0107","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Marekovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Infection Prevention and Control, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1007\/s00467-015-3168-5","article-title":"Acute pyelonephritis in children","volume":"31","author":"Morello","year":"2016","journal-title":"Pediatr. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1586\/14787210.2015.986097","article-title":"The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections","volume":"13","author":"Becknell","year":"2015","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/MOP.0b013e328326f702","article-title":"Diagnosis of urinary tract infections in children","volume":"21","author":"Quigley","year":"2009","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1001\/archpedi.155.1.60","article-title":"Reliability of the urinalysis for predicting urinary tract infections in young febrile children","volume":"155","author":"Bachur","year":"2001","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1542\/peds.111.5.964","article-title":"Serious bacterial infections in febrile infants younger than 90 days of age: The importance of ampicillin-resistant pathogens","volume":"111","author":"Byington","year":"2003","journal-title":"Pediatrics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1080\/14656566.2017.1383383","article-title":"An update on new antibiotic prophylaxis and treatment for urinary tract infections in children","volume":"18","author":"Delbet","year":"2017","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1097\/INF.0000000000002854","article-title":"Resistance to Antibiotics of Uropathogen Bacteria Isolated From Urine and Blood in Pediatric Cancer Patients: A Single Center, 12-year Study","volume":"39","author":"Landi","year":"2020","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.pcl.2006.02.011","article-title":"Pediatric urinary tract infections","volume":"53","author":"Chang","year":"2006","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_9","unstructured":"Pizzo, P.A., and Poplack, D.G. (2006). Principles and Practice of Pediatric Oncology, Lippincott Williams & Wilkins. [5th ed.]."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3109\/08880018.2011.617809","article-title":"Urinary tract infections in pediatric oncology patients with fever and neutropenia","volume":"29","author":"Sandoval","year":"2012","journal-title":"Pediatr. Hematol. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1136\/archdischild-2023-325992","article-title":"Role of urine culture in paediatric patients with cancer with fever and neutropenia: A prospective observational study","volume":"108","author":"Herrero","year":"2023","journal-title":"Arch. Dis. Child."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1093\/cid\/ciz021","article-title":"Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America","volume":"68","author":"Nicolle","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Tigabu, A., Ferede, W., Belay, G., and Gelaw, B. (2020). Prevalence of Asymptomatic Bacteriuria and Antibiotic Susceptibility Patterns of Bacterial Isolates among Cancer Patients and Healthy Blood Donors at the University of Gondar Specialized Hospital. Int. J. Microbiol., 2020.","DOI":"10.1155\/2020\/3091564"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.juro.2013.01.069","article-title":"Antibiotic resistance patterns of outpatient pediatric urinary tract infections","volume":"190","author":"Edlin","year":"2013","journal-title":"J. Urol."},{"key":"ref_15","first-page":"1252","article-title":"Urinary tract infection in children","volume":"82","author":"Larcombe","year":"2010","journal-title":"Am. Fam. Physician."},{"key":"ref_16","first-page":"0306","article-title":"Urinary tract infection in children: Recurrent infections","volume":"2015","author":"Larcombe","year":"2015","journal-title":"BMJ Clin. Evid."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1007\/s00467-019-04316-5","article-title":"Multidrug-resistant organisms in urinary tract infections in children","volume":"35","author":"Mahony","year":"2020","journal-title":"Pediatr. Nephrol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1136\/adc.88.5.444","article-title":"Increasing antibiotic resistance among urinary tract isolates","volume":"88","author":"Ladhani","year":"2003","journal-title":"Arch. Dis. Child."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1086\/508877","article-title":"Bacteremia due to extended-spectrum beta-lactamase-producing Escherichia coli in the CTX-M era: A new clinical challenge","volume":"43","author":"Navarro","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1157\/13070401","article-title":"Etiology and antimicrobial susceptibility among uropathogens causing community-acquired lower urinary tract infections: A nationwide surveillance study","volume":"23","author":"Andreu","year":"2005","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1586\/14787210.2015.991717","article-title":"Evaluation and management of recurrent urinary tract infections in children: State of the art","volume":"13","author":"Awais","year":"2015","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1542\/peds.2008-2583","article-title":"Urinary tract infections in 1- to 3-month-old infants: Ambulatory treatment with intravenous antibiotics","volume":"124","author":"Gauthier","year":"2009","journal-title":"Pediatrics"},{"key":"ref_23","unstructured":"The European Committee on Antimicrobial Susceptibility Testing (2023, December 01). Breakpoint Tables for Interpretation of MICs and Zone Diameters. Version 13.1, 2023. Available online: http:\/\/www.eucast.org."},{"key":"ref_24","unstructured":"CLSI (2020). Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute. [30th ed.]. Available online: https:\/\/clsi.org\/."},{"key":"ref_25","unstructured":"(2023, December 01). Media Preparation for EUCAST Disk Diffusion Testing and for Determination of MIC Values by Broth Microdilution Method. Version 7.0, 2022. Available online: https:\/\/www.eucast.org\/ast_of_bacteria\/disk_diffusion_methodology."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.diagmicrobio.2010.12.002","article-title":"Multiplex PCR for detection of acquired carbapenemase genes","volume":"70","author":"Poirel","year":"2011","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"99","DOI":"10.5847\/wjem.j.1920-8642.2021.02.003","article-title":"Role of urine studies in asymptomatic febrile neutropenic patients presenting to the emergency department","volume":"12","author":"Zgheib","year":"2021","journal-title":"World J. Emerg. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/MPH.0000000000002524","article-title":"Incidence and Causative Organisms of Bacteriuria in Children with Cancer: A 9-Year Experience in a Tertiary Pediatric Center","volume":"45","author":"Mitsuboshi","year":"2023","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ijpam.2017.03.001","article-title":"Patterns of microbial growth in urine cultures in pediatric hematology\/oncology unit over a one-year period: A single institution study","volume":"4","author":"Hirmas","year":"2017","journal-title":"Int. J. Pediatr. Adolesc. Med."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Mancuso, G., Midiri, A., Gerace, E., Marra, M., Zummo, S., and Biondo, C. (2023). Urinary Tract Infections: The Current Scenario and Future Prospects. Pathogens, 12.","DOI":"10.3390\/pathogens12040623"},{"key":"ref_32","unstructured":"Committee for Antibiotic Resistance Surveillance in Croatia (2023). Antibiotic Resistance in Croatia, 2023, The Croatian Acadamy of Medical Sciences."},{"key":"ref_33","unstructured":"Committee for Antibiotic Resistance Surveillance in Croatia (2020). Antibiotic Resistance in Croatia, 2022, The Croatian Acadamy of Medical Sciences."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"dlac128","DOI":"10.1093\/jacamr\/dlac128","article-title":"Variation in antibiotic resistance patterns for children and adults treated at 166 non-affiliated US facilities using EHR data","volume":"5","author":"Sivasankar","year":"2023","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1200\/JCO.22.02224","article-title":"Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update","volume":"41","author":"Lehrnbecher","year":"2023","journal-title":"J. Clin. Oncolog."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1007\/s40121-022-00700-1","article-title":"The Dutch Working Party on Antibiotic Policy (SWAB) Recommendations for the Diagnosis and Management of Febrile Neutropenia in Patients with Cancer","volume":"11","author":"Bruns","year":"2022","journal-title":"Infect. Dis. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Torres, I., Huntley, D., Tormo, M., Calabuig, M., Hern\u00e1ndez-Boluda, J.C., Terol, M.J., Carretero, C., de Michelena, P., P\u00e9rez, A., and Pi\u00f1ana, J.L. (2022). Multi-body-site colonization screening cultures for predicting multi-drug resistant Gram-negative and Gram-positive bacteremia in hematological patients. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07154-3"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1093\/cid\/ciu588","article-title":"Predictive utility of prior positive urine cultures","volume":"59","author":"MacFadden","year":"2014","journal-title":"Clin. Infect. Dis."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/2\/118\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:48:57Z","timestamp":1760104137000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/2\/118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,25]]},"references-count":38,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["antibiotics13020118"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics13020118","relation":{},"ISSN":["2079-6382"],"issn-type":[{"type":"electronic","value":"2079-6382"}],"subject":[],"published":{"date-parts":[[2024,1,25]]}}}