OBJECTIVE : Urinary Tract Infection (UTI) is one of the most common bacterial infections in childhood. The spread of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) has gradually increased worldwide. The aim of this study was to determine the incidence and risk factors of UTI due to ESBL-PE.
METHOD : We retrospectively reviewed medical record and microbiology test results of hospitalized pediatric patients with UTI underwent urine cultures from January-December 2018 in Dr. Kariadi Hospital Semarang. Sociodemographic and clinical features data were taken. Chi square and logistic regression tests were used for statistical analysis.
RESULT : There were 185 positive urine cultures compatible with UTI. Enterobacteriaceae isolates were found in 108 patients (58.4%) and 63.9% (69 isolates) of them were ESBL-PE. Eschericia coli was the most common ESBL-PE (35.7%). Patients referred from other hospitals (72.5%) significantly had greater proportion for infection by ESBL-PE than those from the community (48.7%; odds ratio [OR] 2.898; 95%CI: 1.257 – 6.675; p=0.013). Urinary catheterization (OR 2.695; 95%CI: 1.202 – 6.045; p=0.016), antibiotics usage within 3 months (OR 2.455; 95%  CI:1.072–5.618; p=0.034), and re-hospitalization within the last 1 year (OR 2.982; 95%CI:1.305–6.815; p=0.010) were found as significant risk factors for the ESBL-PE UTI.
CONCLUSION : The incidence of ESBL-PE UTI was high, particularly in patients reffered from other hospitals. Our findings suggest that reducing urinary device use and appropriate use of antibiotic can reduce ESBL-PE infections.