1
|
Barakat AJ, Butler MG. Genetics of anomalies of the kidney and urinary tract with congenital heart disease: A review. Clin Genet 2024. [PMID: 39289831 DOI: 10.1111/cge.14615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 08/21/2024] [Accepted: 08/22/2024] [Indexed: 09/19/2024]
Abstract
Congenital anomalies of the kidney and urinary tract (CAKUT) and congenital heart disease (CHD) are the most common congenital defects and constitute a major cause of morbidity in children. Anomalies of both systems may be isolated or associated with congenital anomalies of other organ systems. Various reports support the co-occurrence of CAKUT and CHD, although the prevalence can vary. Cardiovascular anomalies occur in 11.2% to 34% of patients with CAKUT, and CAKUT occur in 5.3% to 35.8% of those with CHD. The co-occurrence of genetic factors in both CAKUT and CHD would raise common etiologies including genetics, genetic-environmental interactions, or shared molecular mechanisms and pathways such as NODAL, NOTCH, BMP, WNT, and VEGF. Studies in animal models and humans have indicated a genetic etiology for CHD and CAKUT with hundreds of genes recognized and thousands of entries, found in a catalog of human genetic disorders. There are over 80 CAKUT genes and over 100 CHD genes available for clinical testing. For example, the HNFIB gene accounts for 5% to 31% of reported cases of CAKUT. In view of the association between CAKUT and CHD, a thorough cardiac examination should be performed in patients with CAKUT, and a similar evaluation for CAKUT in the presence of CHD. This will allow early diagnosis and therapeutic intervention to improve the long- term outcome of patients affected, and test for at-risk family members. We present here evidence for an association of anomalies involving the two organ systems, and discuss possible etiologies of targeted genes, their functions, biological processes and interactions on embryogenesis.
Collapse
Affiliation(s)
- Amin J Barakat
- Department of Pediatrics, Georgetown University Medical Center, Washington, DC, USA
| | - Merlin G Butler
- Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| |
Collapse
|
2
|
Huang Z, Shen Q, Wu B, Wang H, Dong X, Lu Y, Cheng G, Wang L, Lu W, Chen L, Kang W, Li L, Pan X, Wei Q, Zhuang D, Chen D, Yin Z, Yang L, Ni Q, Liu R, Li G, Zhang P, Qian Y, Peng X, Wang Y, Cao Y, Xu H, Hu L, Yang L, Zhou W. Genetic Spectrum of Congenital Anomalies of the Kidney and Urinary Tract in Chinese Newborn Genome Project. Kidney Int Rep 2023; 8:2376-2384. [PMID: 38025242 PMCID: PMC10658258 DOI: 10.1016/j.ekir.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/07/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Congenital anomalies of the kidney and urinary tract (CAKUT) corresponds to a spectrum of defects. Several large-cohort studies have used high-throughput sequencing to investigate the genetic risk of CAKUT during antenatal, childhood, and adulthood period. However, our knowledge of newborns with CAKUT is limited. Methods This multicenter retrospective cohort study explored the genetic spectrum of CAKUT in a Chinese neonatal cohort. Clinical data and whole exome sequencing (WES) data of 330 newborns clinically diagnosed with CAKUT were collected. WES data were analyzed for putative deleterious single nucleotide variants (SNVs) and potential disease-associated copy number variants (CNVs). Results In this study, pathogenic variants were identified in 61 newborns (18.5%, 61/330), including 35 patients (57.4%) with SNVs, 25 patients (41%) with CNVs, and 1 patient with both an SNV and a CNV. Genetic diagnosis rates were significantly higher in patients with extrarenal manifestations (P<0.001), especially in those with cardiovascular malformations (P<0.05). SNVs in genes related to syndromic disorders (CAKUT with extrarenal manifestations) were common, affecting 20 patients (57.1%, 20/35). KMT2D was the most common gene (5 patients) and 17q12 deletion was the most common CNV (4 patients). Patient 110 was detected with both a CNV (17q12 deletion) and an SNV (a homozygous variant of SLC25A13). Among the newborns with positive genetic results, 22 (36.1%, 22/61) patients may benefit from a molecular diagnosis and change in clinical management (including early multidisciplinary treatment, disease-specific follow-up, and familial genetic counseling). Conclusion This study shows the heterogeneous genetic etiologies in a Chinese CAKUT neonatal cohort by using WES. Patients with CAKUT who have extrarenal manifestations are more likely to harbor genetic diagnoses. Kabuki syndrome and 17q12 deletion syndrome were the most common genetic findings. Approximately 36.1% of the patients may benefit from molecular diagnoses and a change in clinical management.
Collapse
Affiliation(s)
- Zhelan Huang
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Qian Shen
- Department of Nephrology, Children’s Hospital of Fudan University, Shanghai, China
| | - Bingbing Wu
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Huijun Wang
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Xinran Dong
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Yulan Lu
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Guoqiang Cheng
- Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Laishuan Wang
- Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
- Key Laboratory of Birth Defects, Children’s Hospital of Fudan University, Shanghai, China
| | - Wei Lu
- Department of Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Liping Chen
- Jiangxi Provincial Children’s Hospital, Nanchang, China
| | - Wenqing Kang
- Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Long Li
- Department of Neonatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Xinnian Pan
- Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qiufen Wei
- Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | | | - Dongmei Chen
- Quanzhou Women and Children’s Hospital, Quanzhou, China
| | | | - Ling Yang
- Hainan Women and Children’s Medical Center, Haikou, China
| | - Qi Ni
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Renchao Liu
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Gang Li
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Ping Zhang
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Yanyan Qian
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Xiaomin Peng
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Yao Wang
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
- Key Laboratory of Birth Defects, Children’s Hospital of Fudan University, Shanghai, China
| | - Hong Xu
- Department of Nephrology, Children’s Hospital of Fudan University, Shanghai, China
| | - Liyuan Hu
- Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
- Key Laboratory of Birth Defects, Children’s Hospital of Fudan University, Shanghai, China
| | - Lin Yang
- Department of Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Wenhao Zhou
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, China
- Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
- Key Laboratory of Birth Defects, Children’s Hospital of Fudan University, Shanghai, China
- Xiamen Children’s Hospital, Xiamen, China
| |
Collapse
|
3
|
Fernandez N, Varela D, Villanueva J, Lopez Camelo J, Zarante I. Association between Genitourinary and Congenital Heart Defects: A 52-year Case-Control Study of the Latin American Collaborative Study of Congenital Malformations (ECLAMC). Rev Urol 2022. [DOI: 10.1055/s-0042-1746203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
Background Congenital urological anomalies are present in 4.3/10 thousand newborns, and their association with other anomalies may increase the overall mortality and disability. The present study establishes the risk of having congenital urological anomalies presenting associated cardiopathies.
Methods We conducted a retrospective case-control study using the Latin American Collaborative Study of Congenital Malformations (Estudio Colaborativo Latino Americano de Malformaciones Congénitas, ECLAMC, in Spanish). The analysis included all registered cases of congenital urological malformation from 1967 to 2019. Patients with or without associated heart defects were included for the statistical analysis. Odds ratios (ORs) were calculated using a 95% confidence interval (95% CI). We compared the variables with the Chi-squared test and analysis of variance (ANOVA). The statistical analysis was performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 27.0. Values of p < 0.05 were considered statistically significant.
Results A total of 7,767,161 newborns were evaluated, and 17,834 genital and upper urinary tract malformations were identified. Of these, 64.2% were genital anomalies, and 35.8% were abnormalities of the upper urinary tract. Genitourinary malformations and concomitant congenital heart defects (GU + C) were observed in 3.5% of the cases. Subjects with GU + C had a higher number of malformations (4.59 ± 2.3) than patients without heart defects (1.53 ± 1.58) (p < 0.000). The OR was of 3.61 (range: 1.86–7.00) for cloacal exstrophy, of 4.01 (range: 3.14–5.12) for imperforate anus, of 5.52 (range: 3.92–7.78) for horseshoe kidney, and of 13.7 (range: 6.65–28.22) for trisomy 21 (Down syndrome) with malformations of the upper urinary tract.
Conclusion The association of congenital heart defects with urological anomalies is higher for complex congenital anomalies such as imperforate anus, cloacal exstrophy, and horseshoe kidney. Patients with urological abnormalities and Down syndrome have the highest likelihood.
Collapse
Affiliation(s)
- Nicolas Fernandez
- Division of Urology, Department of Pediatric Urology, Seattle Children's Hospital, University of Washington, Seattle, Washington, United States
| | - Daniela Varela
- Research Department, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Juliana Villanueva
- Research Department, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Jorge Lopez Camelo
- Latin American Collaborative Study of Congenital Malformations (ECLAMC), Center for Medical Education and Clinical Research (CEMIC-CONICET), Buenos Aires, Argentina
| | - Ignacio Zarante
- Human Genetics Institute, Pontificia Universidad Javeriana, Bogotá, Colombia
| |
Collapse
|
4
|
Chowdhury D, Toms R, Brumbaugh JE, Bindom S, Ather M, Jaquiss R, Johnson JN. Evaluation and Management of Noncardiac Comorbidities in Children With Congenital Heart Disease. Pediatrics 2022; 150:189884. [PMID: 36317973 DOI: 10.1542/peds.2022-056415e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 02/25/2023] Open
Abstract
Outcomes for patients with neonatal heart disease are affected by numerous noncardiac and genetic factors. These can include neonatal concerns, such as prematurity and low birth weight, and congenital anomalies, such as airway, pulmonary, gastrointestinal, and genitourinary anomalies, and genetic syndromes. This section will serve as a summary of these issues and how they may affect the evaluation and management of a neonate with heart disease. These noncardiac factors are heavily influenced by conditions common to neonatologists, making a strong argument for multidisciplinary care with neonatologists, cardiologists, surgeons, anesthesiologists, and cardiovascular intensivists. Through this section and this project, we aim to facilitate a comprehensive approach to the care of neonates with congenital heart disease.
Collapse
Affiliation(s)
- Devyani Chowdhury
- Cardiology Care for Children, Lancaster, Pennsylvania Nemours Cardiac Center.,These two co-first authors contributed equally to this manuscript
| | - Rune Toms
- Division of Neonatal-Perinatal Medicine, Joe DiMaggio Children's Hospital, Hollywood, Florida.,These two co-first authors contributed equally to this manuscript
| | | | - Sharell Bindom
- Division of Neonatal-Perinatal Medicine, Joe DiMaggio Children's Hospital, Hollywood, Florida
| | - Mishaal Ather
- Cardiology Care for Children, Lancaster, Pennsylvania Nemours Cardiac Center
| | - Robert Jaquiss
- Division of Pediatric and Congenital Cardiothoracic Surgery, Children's Medical Center, Dallas, Texas
| | - Jonathan N Johnson
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic Children's Center, Rochester, Minnesota
| |
Collapse
|
5
|
Alp EK, Dönmez Mİ, Alp H, Elmacı AM. The association between the congenital heart diseases and congenital anomalies of the kidney and the urinary tract in nonsyndromic children. Congenit Anom (Kyoto) 2022; 62:4-10. [PMID: 34397133 DOI: 10.1111/cga.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/04/2021] [Accepted: 07/26/2021] [Indexed: 12/01/2022]
Abstract
Several congenital heart diseases (CHD) are present in children with congenital anomalies of the kidney and the urinary tract (CAKUT) in syndromic or nonsyndromic patterns. The purpose of this study was to identify nonsyndromic children with CAKUT who required echocardiographic evaluation and to find the prevalence of CHD in these patients. Retrospective chart review of nonsyndromic patients with CAKUT between 2012 and 2018 was conducted. Types of congenital anomalies of the kidney and urinary tract and echocardiogram reports of the patients, age, gender, prematurity, prenatal diagnosis of CAKUT, and family history were noted. Among 806 children with CAKUT, 135 patients underwent transthoracic echocardiographic evaluation and CHD was detected in 91 (11.2%). The most common type of CHD was secundum type atrial septal defect that was found in 73 (80.2%) patients. On the other hand, the most frequent types of congenital anomalies of the kidney and the urinary tract were isolated hydronephrosis and primary vesicoureteral reflux (61.4% and 12.8%, respectively). Our results showed that 75.8% of the patients with congenital heart diseases had isolated hydronephrosis. Finally, only 18 (2.2%) cases out of 806 patients that were evaluated via transthoracic echocardiography due to the clinical findings and family history had a CHD that required close (<6 months) follow-up. Congenital heart diseases that required close follow-up are rarely observed in nonsyndromic patients with CAKUT. Therefore, we suggest echocardiography should be performed in cases of clinical suspicion and family history rather than routinely in this patient group.
Collapse
Affiliation(s)
- Esma Keleş Alp
- Department of Pediatrics, Dr. Ali Kemal Belviranlı Women's Maternity and Children's Hospital, Konya, Turkey.,Department of Pediatrics, Karatay University, Konya, Turkey
| | - Muhammet İrfan Dönmez
- Department of Urology, Division of Pediatric Urology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Hayrullah Alp
- Department of Pediatrics, Karatay University, Konya, Turkey.,Department of Pediatric Cardiology, Dr. Ali Kemal Belviranlı Women's Maternity and Children's Hospital, Konya, Turkey
| | - Ahmet Midhat Elmacı
- Department of Pediatrics, Karatay University, Konya, Turkey.,Department of Pediatric Nephrology, Dr. Ali Kemal Belviranlı Women's Maternity and Children's Hospital, Konya, Turkey
| |
Collapse
|
6
|
Khalilian MR, Mollatayefeh A, Tahouri T, Mahdavi A, Dalirani R. Anatomical Findings of Renal and Urological Abnormalities in Cardiac Catheterization of Children with congenital heart diseases - A Single Center Experience. Qatar Med J 2021; 2021:54. [PMID: 34722221 PMCID: PMC8529198 DOI: 10.5339/qmj.2021.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/02/2021] [Indexed: 11/03/2022] Open
Abstract
ackground and aims: Congenital heart disease (CHD) is described as an abnormality in the heart structure or intra-thoracic great vessels that leads to functional problems. Since most of these disorders require medical and surgical interventions identifying concomitant disorders such as renal and urinary tract abnormalities is of great importance in the management of these patients. The present study aimed to investigate the relative frequency of abnormal kidney and urinary tract findings in abdominal cineangiography during cardiac catheterization of patients with CHD in Shahid Modarres Cardiovascular Medical and Research Center. METHODS The present study was performed prospectively on 545 patients aged < 18 years with CHD who underwent cardiac catheterization and concurrent abdominal cineangiography in Shahid Modarres Cardiovascular, Medical and Research Center, Tehran, Iran during a three-year period. The required data were extracted using a researcher-made questionnaire from patients' electronic medical files. RESULTS Of a total of 545 patients in this study, 26 had both CHD and renal or urinary tract malformation. Patent ductus arteriosus was the most common CHD in patients with renal or urinary tract malformations (odds ratio: 1.2, 95%, CI: 2.25-11.63). In this study, the most common renal and urinary malformations among CHD patients was partial duplication of the kidney followed by Ureteropelvic Junction Obstruction. CONCLUSION Since the prevalence of renal and urinary tract malformations is higher in CHD patients, performance of concurrent abdominal cineangiography during cardiac catheterization may lead to early diagnosis and treatment as well as better pre- and post-operative management of patients.
Collapse
Affiliation(s)
- Mohammad Reza Khalilian
- Department of Pediatrics, School of Medicine, Shahid Modarres cardiovascular Medical and Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Mollatayefeh
- Department of Pediatrics, School of Medicine, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tahmineh Tahouri
- Department of Pediatrics, School of Medicine, Shahid Modarres cardiovascular Medical and Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Mahdavi
- Department of Radiology, School of Medicine, Shahid Modarres Hospital, Shahid Beheshti, University of Medical Sciences, Tehran, Iran
| | - Reza Dalirani
- Department of Pediatrics, School of Medicine, Pediatric Nephrology Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Esposito C, Escolino M, Autorino G, Borgogni R, Paternoster M, Coppola V, Esposito G, Castagnetti M, Cardone R, Graziano V, Cerulo M. Laparoscopic Partial Nephrectomy for Duplex Kidneys in Infants and Children: How We Do It. J Laparoendosc Adv Surg Tech A 2021; 31:1219-1223. [PMID: 34492206 DOI: 10.1089/lap.2021.0396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Duplication anomalies of the kidney represent common congenital malformations of the urinary tract. A duplex kidney has often one pole that is poorly or nonfunctioning. In this last case, surgery may be indicated to remove the nonfunctioning pole. The most common indications for partial nephrectomy in pediatrics include symptomatic vesicoureteral reflux to the nonfunctioning pole and/or ectopic ureter or ureterocele causing urinary incontinence. In this article, we describe the technique of laparoscopic partial nephrectomy in infants and children with duplex kidney. A surgical procedure properly executed following critical technical steps is the key factor for the success of surgery.
Collapse
Affiliation(s)
- Ciro Esposito
- Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy
| | - Maria Escolino
- Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy
| | - Giuseppe Autorino
- Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy
| | - Rachele Borgogni
- Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy
| | - Mariano Paternoster
- Department of Advanced Biomedical Science, Federico II University of Naples, Naples, Italy
| | - Vincenzo Coppola
- Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy
| | - Giorgia Esposito
- Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy
| | | | - Roberto Cardone
- Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy
| | - Vincenzo Graziano
- Department of Advanced Biomedical Science, Federico II University of Naples, Naples, Italy
| | - Mariapina Cerulo
- Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy
| |
Collapse
|
8
|
Isac R, Basaca DG, Olariu IC, Stroescu RF, Ardelean AM, Steflea RM, Gafencu M, Chirita-Emandi A, Bagiu IC, Horhat FG, Vulcanescu DD, Ionescu D, Doros G. Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract. CHILDREN-BASEL 2021; 8:children8070585. [PMID: 34356564 PMCID: PMC8304885 DOI: 10.3390/children8070585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 01/03/2023]
Abstract
Background: Urinary tract infections (UTI) are common in children worldwide. Congenital anomalies of kidney and urinary tract (CAKUT) increase the risk of UTI and consequently antibiotic resistance. Antibiotic resistance represents an important public health issue worldwide. We aimed to evaluate the local trend in terms of bacterial uropathogen resistance in the western part of Romania in children with CAKUT and UTI. Methods: 252 children with CAKUT were admitted to our hospital over a five-year period. Of them, 91 developed at least one UTI episode, with a total number of 260 positive urine cultures. We collected data about age at diagnosis of CAKUT, sex, origin environment, type and side of CAKUT, number of UTIs, type of uropathogen, and uropathogens antibiotic resistance. Results: Distribution of uropathogens was Escherichia coli (38.84%), Klebsiella spp. (21.15%), Enterococcus spp. (15.76%), Proteus spp. (8.07%), Pseudomonas spp. (8.07%), Enterobacter spp. (2.3%), other Gram-negative bacteria (2.3%), and other Gram-positive bacteria (3.45%). High antibiotic resistance was detected for ampicillin, amoxicillin, and second-generation cephalosporins. Escherichia coli presented high resistance for cefepime and ceftriaxone. Pseudomonas spp. remained susceptible to amikacin, quinolones, and colistin. Vancomycin, teicoplanin, linezolid, and piperacillin/tazobactam remained effective in treating Gram-positive UTI. Conclusions: High antibiotic resistance was identified for frequently used antibiotics. Lower antibiotic resistance was observed for some broad-spectrum antibiotics. Understanding uropathogens’ antibiotic resistance is important in creating treatment recommendations, based on international guidelines, local resistance patterns, and patient particularities.
Collapse
Affiliation(s)
- Raluca Isac
- IIIrd Pediatric Clinic, Department of Pediatrics, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 300041 Timișoara, Romania; (R.I.); (I.-C.O.); (A.-M.A.); (R.M.S.); (M.G.); (G.D.)
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
| | - Diana-Georgiana Basaca
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
| | - Ioana-Cristina Olariu
- IIIrd Pediatric Clinic, Department of Pediatrics, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 300041 Timișoara, Romania; (R.I.); (I.-C.O.); (A.-M.A.); (R.M.S.); (M.G.); (G.D.)
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
| | - Ramona F. Stroescu
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
- Ist Pediatric Clinic, Department of Pediatrics, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 300041 Timișoara, Romania
| | - Andrada-Mara Ardelean
- IIIrd Pediatric Clinic, Department of Pediatrics, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 300041 Timișoara, Romania; (R.I.); (I.-C.O.); (A.-M.A.); (R.M.S.); (M.G.); (G.D.)
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
| | - Ruxandra M. Steflea
- IIIrd Pediatric Clinic, Department of Pediatrics, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 300041 Timișoara, Romania; (R.I.); (I.-C.O.); (A.-M.A.); (R.M.S.); (M.G.); (G.D.)
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
| | - Mihai Gafencu
- IIIrd Pediatric Clinic, Department of Pediatrics, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 300041 Timișoara, Romania; (R.I.); (I.-C.O.); (A.-M.A.); (R.M.S.); (M.G.); (G.D.)
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
| | - Adela Chirita-Emandi
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
- Department of Microscopic Morphology, Genetics Discipline, Center of Genomic Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Iulia Cristina Bagiu
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Correspondence: (I.C.B.); (F.G.H.)
| | - Florin George Horhat
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Correspondence: (I.C.B.); (F.G.H.)
| | - Dan-Dumitru Vulcanescu
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
| | - Dan Ionescu
- Physical Education and Sports Department, Polytechnic University, 300223 Timișoara, Romania;
| | - Gabriela Doros
- IIIrd Pediatric Clinic, Department of Pediatrics, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 300041 Timișoara, Romania; (R.I.); (I.-C.O.); (A.-M.A.); (R.M.S.); (M.G.); (G.D.)
- Emergency Hospital for Children “Louis Turcanu”, 300011 Timișoara, Romania; (D.-G.B.); (R.F.S.); (A.C.-E.); (D.-D.V.)
| |
Collapse
|