Profil épidémiologique et facteurs de risque des infections urinaires communautaires à entérobactéries BLSE chez l’enfant Tunisien

INTRODUCTION: The rise in community-acquired urinary tract infections (UTI) caused by enterobacteria strains producing extended spectrum beta-lactamase (ESBL) in children has complicated treatment strategies. OBJECTIVE: This study aimed to evaluate risk factors associated with ESBL-producing UTIs in pediatric patients and analyze the antibiotic resistance patterns of the causative pathogens. METHODS: A six-year cross-sectional study (January 2019-December 2024) was conducted at Sahloul University Hospital's pediatric department, including children under 15 years hospitalized with community-acquired UTIs. RESULTS: A total of 383 UTI were included with 20.4% of UTI caused by ESBL producing strains. Females represented 62.66% (sex ratio=0.59). The median patient age was 11 months [3-66]. Escherichia coli and Klebsiella pneumoniae were the most common isolates (80.4% and 12.27%). Common risk factors included prior antibiotic use (41%), hospitalization in the past year (30.81%), recurrent UTIs (20.89%), and the presence of malformative uropathy (8.62%). Multivariate analysis confirmed only prior hospitalization (≤12 months) as an independent factor with ESBL strains (p = 0.005). CONCLUSION: The increasing prevalence of ESBL-related UTIs in children calls for stricter antibiotic stewardship and ongoing surveillance of resistance trends in this population.