• Lu Keshi, Xiao Weiwei, Li Shoulin, Liu Xiadong, Wang Hao, Jiang Junhai, Wang Xiangwei, Wang Rui, and Zhu Pei.
• Department of Urology, Shenzhen Children's Hospital,Shenzhen,Guangdong Province, China. E-mail. keshilu@szu.edu.cn.
• Saudi Med J. 2019 Nov 1; 40 (11): 1111-1115.

ObjectivesTo investigate the drug resistance of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli ) and Klebsiella pneumoniae (K. pneumoniae) in children with urinary tract infection  (UTI) and to provide the rationale for clinical use of antibiotics.MethodsThis is a retrospective analysis of drug susceptibility in children with E. coli or K. pneumoniae-positive urine culture between August 2013 and August 2017,  Shenzhen Children's Hospital, Shenzhen, China. Drug resistance was statistically assessed using Fisher exact test and χ2 test.ResultsA total of 698 cases of E. coli, 426 of which were confirmed ESBL-producing strains, and 217 cases of K. pneumoniae, including 111 ESBL-producing strains, were detected, and the difference in proportion of positive ESBL-producing strains (61.03% versus 51.15%) was statistically significant (p=0.010). The average drug resistance rates of E. coli and K. pneumoniae to piperacillin/tazobactam, meropenem, ertapenem, imipenem, and amikacin were less than 15%. The average resistance rates of ESBL-producing E. coli and K. pneumoniae to cefpodoxime, cefixime, cefazolin, and ceftriaxone was less than 98%, while average resistance rates for non-ESBL-producing bacteria to the above 4 drugs was less than 20%.ConclusionIn southern China, the proportion of ESBL-producing strains and the drug resistance rates of E. coli and K. pneumoniae in UTI in children was high, but their resistance rates to carbapenems and β-lactamase inhibitor complexes containing tazobactam were low. Carbapenems are the most effective antibacterial drugs for the treatment of ESBL-producing bacteria.

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