Potential Perinatally Acquired Extended Spectrum β-Lactamase Escherichia coli Urinary Tract Infection in an Infant

• Published in: The journal of pediatric pharmacology and therapeutics 2020, Vol.25 (3), p.266-269
• Main Authors: Ziegler, Jason, Chapman, Heather, Rueth, Megan, Hays, Annette, Schriever, Christopher, Tsaras, Geoffrey
• Format: Article
• Language: English
• Subjects: Case Reports
• ISSN: 1551-6776; 2331-348X
• DOI: 10.5863/1551-6776-25.3.266

Extended-spectrum β-lactamases (ESBL) are produced mainly by members of the Enterobacteriaceae family and 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 devices (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 carbapenems, with some supportive literature regarding the utility/effectiveness of other non-β-lactam therapy. We present a 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.