Urinary tract infections in children < 2 years of age hospitalized in a tertiary medical center in Southern Israel: epidemiologic, imaging, and microbiologic characteristics of first episode in life

  • David Shaki
  • Gabriel Hodik
  • Siham Elamour
  • Raouf Nassar
  • Eyal Kristal
  • Ron Leibovitz
  • Amir Horev
  • Eugene LeibovitzEmail author
Original Article


The objectives of the study were to describe the epidemiologic, microbiologic, and imaging characteristics of first 44 UTI episode in hospitalized infants and children < 2 years of age. A UTI episode was diagnosed based on suprapubic aspiration or urinary catheterization and report of a significant bacterial growth of true uropathogens. Two thousand two hundred ninety-four UTI episodes were recorded during 2009–2013 in 1694 patients; 1350 (79.7%), 223 (13.2%), and 66 (3.9%) had one, two, and three episodes, respectively. Of 1955 pathogens isolated, the most frequent were E. coli, Klebsiella spp., and Enterococcus spp. (56.9%, 14.1%, and 11%, respectively). E. coli percentages increased with increase in patient age while Klebsiella spp. and Enterococcus spp. decreased with decrease in age. 136/344 (39.5%) renal ultrasound examinations performed were reported abnormal. The percentages of abnormal ultrasound examinations in Enterococcus spp.-UTI were higher than in E. coli and Klebsiella spp.-UTI (P < 0.001 and P = 0.007, respectively). The E. coli nonsusceptibility to ampicillin, TMP/SMX, ceftriaxone, amoxicillin/clavulanic acid, cefuroxime, and gentamicin was 71%, 31%, 14.9%, 14.7%, 7%, and 4.4%, respectively. Nonsusceptibility of Klebsiella spp. to ampicillin, amoxicillin/clavulanic acid, TMP/SMX, ceftriaxone, gentamicin, and cefuroxime was 98.7%, 10.4%, 9.5%, 8.4%, 4.8%, and 4.3%, respectively. E. coli nonsusceptibility to amoxicillin/clavulanate, TMP/SMX, and ciprofloxacin decreased during the study period. E. coli percentages increased and those of Klebsiella spp. and Enterococcus spp. decreased with increase in patient age. Enterococcus. spp.-UTI was associated with older age and more severe findings on renal ultrasound. E. coli and Klebsiella spp. nonsusceptibility to amoxicillin/clavulanate, TMP/SMX, cefuroxime, and ceftriaxone was low.


Urinary tract infection Infants Escherichia coli Ultrasound Antibiotics 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The research protocol was approved by the Ethics Committee of the Soroka University Medical Center.

Informed consent

Retrospective research, informed consent not needed.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  • David Shaki
    • 1
    • 2
  • Gabriel Hodik
    • 3
  • Siham Elamour
    • 1
    • 2
  • Raouf Nassar
    • 1
  • Eyal Kristal
    • 1
  • Ron Leibovitz
    • 1
  • Amir Horev
    • 1
  • Eugene Leibovitz
    • 1
    • 2
    Email author
  1. 1.Division of PediatricsSoroka University Medical Center, Ben-Gurion UniversityBeer ShevaIsrael
  2. 2.Pediatric Infectious Disease UnitSoroka University Medical Center, Ben-Gurion UniversityBeer ShevaIsrael
  3. 3.Sackler Faculty of Medicine, Tel Aviv UniversityTel AvivIsrael

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