Evidence map›Paper›PMID 38565823›Full record

ArticleIrish journal of medical science2024

Paediatric Escherichia coli urinary tract infection: susceptibility trends and clinical management-a retrospective analysis of a 10-year period.

Seán Olann Whelan, Sarah Kyne, Andrew Dore, Mark Glynn, Frances Higgins, Belinda Hanahoe, Frank Moriarty, Edina Moylett, Martin Cormican

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Article in Irish journal of medical science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Evidence for antimicrobial stewardship and reduced antimicrobial resistance in the Mid-West of Ireland, 2012 to 2023: findings from a One Health study.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025
    Article
  4. Antimicrobial Susceptibility Trends inPathogens (Basel, Switzerland) · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Seán Olann WhelanDivision of Clinical Microbiology, Galway University Hospitals, Galway, Ireland. s.whelan@rocketmail.com.ORCID http://orcid.org/0000-0002-0272-2889
Sarah KyneDepartment of Paediatrics, Galway University Hospitals, Galway, Ireland.
Andrew DoreDepartment of Paediatrics, Galway University Hospitals, Galway, Ireland.
Mark GlynnDepartment of Paediatrics, Galway University Hospitals, Galway, Ireland.
Frances HigginsDivision of Clinical Microbiology, Galway University Hospitals, Galway, Ireland.
Belinda HanahoeDivision of Clinical Microbiology, Galway University Hospitals, Galway, Ireland.
Frank MoriartySchool of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Edina MoylettDepartment of Paediatrics, Galway University Hospitals, Galway, Ireland.
Martin CormicanDivision of Clinical Microbiology, Galway University Hospitals, Galway, Ireland.
University Hospital Galway · IEOllscoil na Gaillimhe – University of Galway · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEscherichia coli is the predominant urinary pathogen in children. Irish and international studies have demonstrated increasing antimicrobial resistance (AMR) to antibiotics such as co-amoxiclav.

aimsWe aimed to (1) examine the AMR patterns of paediatric urinary E. coli isolates, from both hospital and community sources, over a 10-year period; (2) assess the effectiveness of Children's Health Ireland (CHI) antimicrobial guidance given local susceptibility data; and (3) review the clinical management of an admitted patient sub-set over a 6-year period.

methodsPure growth of urinary E. coli from patients aged ≤ 14 from 2012 to 2021 were analysed for AMR. Differences in susceptibility rates were assessed. A retrospective chart review conducted on inpatients aged ≥ 2 months to ≤ 14 years, 2016-2021.

resultsE. coli accounted for 70.8% of likely significant positive pure growth cultures (9314 isolates). Susceptibility to co-amoxiclav significantly increased over time, from 66.7% to 80.4% (2016-2021, p < 0.001). Nitrofurantoin and cefalexin had significantly higher susceptibility rates than trimethoprim (< 70% annually). 85.1% of isolates were susceptible to the combination of co-amoxiclav and gentamicin, recommended for those > 2months and systemically unwell. The additional gain in empiric susceptibility provided by gentamicin above that provided by co-amoxiclav alone has fallen from 16.4% to 6.7% (2016-2021). The 222 clinical cases reviewed showed improved antimicrobial guideline compliance over time.

conclusionsThis study provides important regional AMR data. Co-amoxiclav susceptibility increased significantly over time, contrasting with previous studies. This was temporally associated with stewardship measures reducing co-amoxiclav prescribing. Decreasing utility of gentamicin supports recent CHI guideline updates reducing gentamicin use.

Indexed as

Anti-Bacterial AgentsEscherichia coliEscherichia coli InfectionsUrinary Tract InfectionsAdolescentAmoxicillin-Potassium Clavulanate CombinationChildChild, PreschoolDrug Resistance, BacterialFemaleHumansInfantIrelandMaleMicrobial Sensitivity TestsNitrofurantoinAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial AgentsNitrofurantoinTrimethoprimAntimicrobial guidanceAntimicrobial resistancePaediatricsUrinary tract infection

Identifiers

PMID38565823
OpenAlexW4393869685

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.