Potential perinatally acquired extended spectrum β-lactamase escherichia coli urinary tract infection in an infant

Abstract

Extended-spectrum β-lactamases (ESBL) are produced mainly by members of the Enterobacteriaceae famiand confer resistance to most β-lactam antibiotics. Because of limited treatment options, ESBL infections are typically more challenging to treat resulting in poor outcomes, increased complications, and mortality. Because ESBL-producing organisms are primarily seen in critically ill patients, along with those patients having prolonged hospital stays, extensive courses of antimicrobials, and/or use of invasive medical device(i.e., urinary catheters, central venous lines, or endotracheal tubes), guidelines regarding the management of ESBL-producing organisms in the pediatric population are scant. A review of current recommended treatment options for infections caused by ESBL-producing organisms centers on the use of carbapenemswith some supportive literature regarding the utility/effectiveness of other non-β-lactam therapy. We presea case report of an 8-month-old female diagnosed with a urinary tract infection due to ESBL-producing Escherichia coli successfully treated with sulfamethoxazole/trimethoprim. Multidrug resistant infections in pediatric patients without risk factors remains an important field of study because these unique infections may pose a problem when choosing an effective empiric antimicrobial therapy. ABBREVIATIONS AAP, American Academy of Pediatrics; CBC, complete blood count; CFU, colony-forming unit; E coli, Escherichia coli; ESBL, extended-spectrum β-lactamase; IM, intramuscular; MDR, multidrug resistant; UTI, urinary tract infection; WBC, white blood cell.