374 Plasma exchange in paediatric nephrology – the irish experience

Abstract

Introduction Febrile urinary tract infections (FUTIs) are a common reason of consultation and hospitalization in pediatric clinical practice generating important health care costs. Strains of multidrug-resistant bacteria responsible for FUTIs are currently emerging, which can, in many cases, lead to therapeutic dead-ends. However, the changing epidemiological and bacteriological profiles of FUTIs in children over the past years haven't been studied in Tunisia.The main purpose of this study was to analyze the evolution of epidemiological and bacteriological profiles of FUTIs in children. Methods It was a descriptive, analytical and retrospective study over two periods (2000-2005 and 2010-2015), conducted in the department of pediatrics C at the children's hospital Bechir Hamza of Tunis. We included all children who were hospitalized for confirmed FUTIs. Results This study enrolled 254 patients divided into 2 groups: group 1 which included 105 patients from the first study period and group 2 which included 149 patients of the second period of study. The average age was significantly lower in group 2 (51.2±39.7 months versus 32.2±38.4 months; p<0.001) with a female predominance in both groups. A history of malformativeuropathies and UTIs was more common in the first study group.Clinical features were similar in both groups. Escherichia coli (E. coli) was the most frequently isolated germ. The antibiograms showed an increase in the resistance rates of E. coli to ampicillin, third generation cephalosporins and gentamicin during the second period of study as compared to the first period. Imipenem and amikacin kept a zero resistance rate between the two periods of the study. Conclusion Antibiotic resistance rates in upper UTIs have increased significantly over the past years. Preventing those risks requires a more rational prescription of antibiotics.