الفهرس 
URINARY TRACT INFECTIONOnly 14 pages are availabe for public view
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Abstract
U
rinary tract infection (UTI) in children is a frequent cause of worry for parents and physicians.when UTI does notresolve completely, it will lead to complication. so we need accurate diagnosis and treatment to decrease the increased risk of extended spectrum B-lactamases (ESBL) bacteria causing UTI in children.
Extended-spectrum-beta-lactamases have spread widely worldwide among the Enterobacteriaceae, predominantly in Klebsiella, E.coli and Proteusspp. Organisms producing ESBL have traditionally been responsible for serious UT infections that are often occur in outbreaks and are usually exhibiting an extremely resistant with a very limited therapeutic choices and therefore they usually associated with increased morbidity, mortality, and health-care associated costs.
Continuous microbiological screening for ESBLs is extremely important for implementing appropriate measures for their prevention and control.
The risk factor of UTI in children are obstruction of the urinary tract that is associated with urinary tract infection may be either anatomic or functional in nature. anatomic obstruction with infection included posterior urethral valves, ureteropelvic junction or ureterovesical junction obstruction, and ureterocele.Although the presence of these abnormalities does not necessarily predispose the individual to UTI, the potential for renal damage is much greater if infections supervenes. The role of anatomic urethral stenosis, formerly considered a significant predisposing factor to UTI and Voiding dysfunction including detrusor instability with or without urethral hyperactivity and infrequent voiding are significance in the pathogenesis of UTI.
In the current study, we screened for ESBL production among all specimens of UT infections caused by E.coli, klebsiella, and Proteus isolates (n=200) received at Ain Shams University microbiology laboratory. We found that the overall prevelance of ESBL among all the isolates of E.coli, Klebsiella and Proteus spp. during the study period of one year was 50% (100/200), with a prevelance of 18% among E.coli isolates (18/100), 62% among Klebsiella spp. isolates (62/100) and 20% among Proteus spp. isolates (20/100).
The present study showed that the overall prevelance of ESBL among all the isolates were 50% (100/200) and the overall prevelance of non ESBL among all the isolates were 50% (100/200) and the studied ESBL isolates were characterized with the high sensitivity to the ertapenem (80%).
Ertapenem is the parenteral broad-spectrum carbapenem with in vitro high activity against ESBL- producing Enterobacteriacease such as klebsiella pneumonia, E.coli andProteus spp.The increased use of cabapenems has been driven by the accumulation of cephalosporin and fluroroquinolone resistance among Enterobacteriacease.