Epidemiological profile and risk factors of community-acquired caused by enterobacteria strains producing ESBL urinary tract infections in Tunisian children

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Published Mar 10, 2026
https://doi.org/10.62438/tunismed.v104i01.6232
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Vol. 104 No. 01 (2026): Tunis Med Jan 2026

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Selsabil Nouir
Department of pediatrics, Hospital of Sahloul, Sousse, faculty of medicine of Sousse, University of Sousse, 4002, Tunisia
Sameh Mabrouk
Department of pediatrics, Hospital of Sahloul, Sousse, faculty of medicine of Sousse, University of Sousse, 4002, Tunisia
https://orcid.org/0000-0001-7052-8829
Sirine Mansar
Department of pediatrics,Centre Hospitalier Sud Francilien, Faculty of medicine, University of Paris cité, 91100,Paris, France
Safa Hannachi
Department of pediatrics, Hospital of Sahloul, Sousse, faculty of medicine of Sousse, University of Sousse, 4002, Tunisia
Farah Azouzi
Laboratory of microbiology, Hospital of Sahloul, Sousse,Faculty of medicine of Sousse,University of Sousse, 4002, Tunisia
raja Boukadida
Department of nephrology, Hospital of Sahloul, Sousse, Faculty of medicine of Sousse,University of Sousse, 4002,Tunisia
Azza Harbi
Department of pediatrics, Hospital of Sahloul, Sousse, faculty of medicine of Sousse, University of Sousse, 4002, Tunisia
Hajer Mokni
Department of pediatrics, Hospital of Sahloul, Sousse, faculty of medicine of Sousse, University of Sousse, 4002, Tunisia
Houda Ajmi
Department of pediatrics, Hospital of Sahloul, Sousse, faculty of medicine of Sousse, University of Sousse, 4002, Tunisia

Abstract

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.

Keywords:

Urinary tract infections , Child, antibiotic resistance , risk factor

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