Antibiotic resistance of urinary tract pathogens and rationale for empirical intravenous therapy

Haller, Maria; Brandis, M.; Berner, Reinhard

doi:10.1007/s00467-004-1528-7

Cited by 73 publications

(61 citation statements)

References 22 publications

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“…[6,14,[18][19][20][21][22]26,[29][30][31][32][33] In studies performed hitherto, K. pneumonia has been isolated as a responsible uropathogen in 10% of the cases with UTI. [17][18][19][21][22][23][24][25][26]28,[32][33][34] In compliance with previous publications, antimicrobial resistance rate was detected as 12.1 percent. In a study reported from Tunisia, increased rates of antibiotic resistance of K. pneumonia were reported against amoxicillin/clavulanate, amoxicillin and cephalosporins in Tunisia, and and against nalidixic acid, and amoxicillin/clavulanate in Yemen.…”

Section: Discussionsupporting

confidence: 53%

Antibiotic sensitivity and resistance in children with urinary tract infection in Sanliurfa

Abuhandan

Güzel

Oymak

et al. 2013

Turkish Journal of Urology

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Objective: This study aimed to evaluate antibiotic resistance in the province of Şanliurfa and to observe any difference between antibiotic resistance rates. Material and methods:The study comprised 107 children who presented at the pediatric polyclinic with complaints of urinary tract infection with the diagnosis of urinary tract infection and whose urine cultures exhibited bacterial growth. The patients were analyzed with respect to the frequency of proliferating pathogens, sensitivity to the antibiotics used and the rates of developed resistance to the antibiotics.Results: A total of 107 patients aged between 1 year and 15 years were included in the study, encompassing 14 (13.1%) males and 93 (86.9%) females. According to the urine culture results, proliferation of Escherichia coli (E. coli) was observed in 69 (64.5%), Klebsiella spp. in 13 (12.1%), Proteus mirabilis in 9 (8.4%), Staphylococcus aureus in 5 (4.7%), Pseudomonas aeruginosa in 5 (4.7%), Acinetobacter spp. in 3 (2.8%) and Enterococcus spp. in 3 (2.8%) patients. For proliferating E. coli, high resistance rates to ceftriaxone (39.5%), nitrofurantoin (19.7%), ampicillin-sulbactam (64.1%), co-trimoxazole (41.5%), amoxicillinclavulanate (51.7%) and cefuroxime (38.1%) were observed. All of isolated microorganisms were resistant to ampicillin-sulbactam, amoxicillin-clavulanate, co-trimoxazole, ceftriaxone, cefuroxime and cefoxitin in decreasing frequencies. The most effective antimicrobial agents were determined to be imipenem, sulperazone, quinolone and aminoglycosides. Conclusion:In our region, parenteral antibiotics that should be selected for the empirical treatment of UTIs in all age groups are the aminoglycosides and 3 rd generation cephalosporines. In contrast to other studies, these results suggest that co-trimoxazole should be used for children aged 0-1, and 2 nd generation cephalosporins should be used for the oral treatment of children aged 1-5 due to the low rate of resistance to nitrofurantoin in patients aged over 5 years.

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Section: Discussionsupporting

confidence: 53%

Antibiotic sensitivity and resistance in children with urinary tract infection in Sanliurfa

Abuhandan

Güzel

Oymak

et al. 2013

Turkish Journal of Urology

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“…Other studies in Iran have also revealed a similar resistance rate of E.coli isolated from out-and-in children patients with UTI; 25%, 18.1%, and 23.5% in Tehran (14), and 21.5%, 9.9%, and 22.4% in Ghazvin (15) to CTX, AMK, and GEn respectively. However, lower resistance rates were reported in some developing (16,17) and developed countries (8,11,18,19). These patterns of susceptibility put a patient with UTI at 22.8%, 30%, 9% and 23% risk of resistance to CTX, CFX, AMK, and GEn, respectively (Table-2).…”

Section: Discussionmentioning

confidence: 98%

“…implications for the empirical use of antibiotics (8,9). When prescribing empirical therapy for infections in the community and in the hospital, it is important to know the national and local antibiotic resistance patterns of different organisms.…”

mentioning

confidence: 99%

“…When prescribing empirical therapy for infections in the community and in the hospital, it is important to know the national and local antibiotic resistance patterns of different organisms. This requires permanent monitoring to gatter information for providing new therapeutic options (7)(8)(9). The aim of this study was to determine the relative frequency of bacterial species causing UTI and their susceptibility patterns to most commonly used antibiotics during a four years-study period (2006)(2007)(2008)(2009).…”

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confidence: 99%

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Increasing antibiotic resistance among uropathogens isolated during years 2006-2009: impact on the empirical management

et al. 2012

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Urinary tract infections (UTI) are one of the most common infections with an increasing resistance to antimicrobial agents. PURPOSE: Empirical initial antibiotic treatment of UTI must rely on susceptible data from local studies. MATERIALS AND METHODS: Retrospective analysis of isolated bacteria from children with UTIs was performed at the university hospital during years 2006-2009. The findings were compared with data collected in a similar study carried out in 2002- 2003. RESULTS: A total of 1439 uropathogens were isolated. Escherichia coli (E.coli) was the leading cause, followed by Enterobacter, and other gram negative bacilli. It was observed resistance of E.coli to ceftriaxone, cefexime, amikacin, gentamycin, and nalidixic acid; Enterobacter to cefexime; and the resistance of gram negative bacilli to gentamicin and cefexime increased significantly. The highest effective antibiotic was Imipenem, ciprofloxacin, and amikacin with 96.7%, 95% and 91% sensitivity rates , respectively, followed by ceftriaxone 77.2%, gentamicin 77%, nitrofurantoin 76.4%, nalidixic acid 74.3% and cefexime with 70%. CONCLUSION: The use of nitrofurantoin or nalidixic acid as initial empirical antibacterial therapy for cystitis seems appropriate. For cases of simple febrile UTI, the use of initial parenteral therapies with amikacin or ceftriaxone followed by an oral third generation cephalosporin also seemed appropriated, and in cases of severely ill patients or complicated UTI, imipenem as monotherapy or, a combination of Ceftriaxone with an aminoglycoside, are recommended

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“…In many countries, the most common antibiotic resistance in isolated species is against ampicillin. The probability of resistance development against ampicillin was determined as 45%, 50%, and 100% in children living in Canada, Europe, and Africa, respectively (17)(18)(19)(20). Ampicillin is not recommended alone in the treatment of UTIs,…”

Section: Discussionmentioning

confidence: 99%

Effect of Prophylactic Antibiotic Use in the Development of Antibiotic Resistance in Children with Recurrent Urinary Tract Infections

Karacı¹,

Karagöz²,

Örnek³

et al. 2017

Haseki

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Aim:Although prophylactic antibiotic treatment is still debatable, it is currently in use in recurrent urinary tract infections (UTIs). In the present study, we aimed to observe if prophylactic antibiotic use had any effect on the development of antibiotic resistance in patients with recurrent UTIs who we followed up in our clinic. Methods: The present study was performed on patients aged between one month and 16 years, who had recurrent UTIs, and were followed up by the Department of Pediatrics at Bülent Ecevit University Medical School. Patient files were retrospectively reviewed, and 50 patients who received antibiotic prophylaxis and 100 patients without prophylaxis were enrolled in the study. Urinary tests, subsequent urinary culture results, and antibiotic resistances were compared between the groups. Results: The mean age was 42.7±44.2 months. The most frequently cultured isolated bacterium was Escherichia coli (E. coli) (58.4%). No difference was determined in bacteria in cultures between prophylaxis receivers and non-receivers. Isolation rate of E. coli was higher in urinary cultures in females than in males (p<0.001). When antibiotic resistance of all urinary culture-isolated bacteria was compared between the two groups, there was no statistically significant difference. However, an increased resistance against amoxicillin/clavulanic acid, ceftriaxone, and piperacillin was determined in prophylaxis group in whom E. coli was grown. In this study, general antibiotic resistance was most frequently observed against ampicillin (71.9%). Conclusion:In the present study, we observed that prophylaxis did not contribute so much to resistance other than E. coli. We recommend not preferring antibiotics which have increased resistance in our institution especially in children receiving prophylaxis for empirical treatment. Keywords: Childhood, urinary tract infection, prophylaxis, antibiotic resistance Amaç: Tekrarlayan idrar yolu enfeksiyonlarında (İYE) antibiyotik proflaksisi günümüzde tartışmalı da olsa kullanılmaya devam edilmektedir. Biz bu çalışmada, kendi kliniğimizde takip ettiğimiz tekrarlayan İYE'de kullanılan profilaksinin antibiyotik direnç gelişimine etkisinin olup olmadığını gözlemlemeyi amaçladık. Yöntemler: Bu çalışma Bülent Ecevit Üniversitesi Tıp Fakültesi Pediatri Departmanı'nca takip edilen bir ay ile 16 yaş arası tekrarlayan idrar yolu enfeksiyonu olan hastalarda yapılmıştır. Hasta dosyaları retrospektif olarak taranarak antibiyotik proflaksisi alan 50 ve almayan 100 hasta çalışmaya dahil edildi. Hastaların idrar tetkikleri, sonraki kültürlerindeki üremeleri ve bunların antibiyotik dirençleri gruplar arasında karşılaştırıldı. Bulgular:Hastaların %43,3 erkek, %56,7 kızlardan oluşmaktaydı ve ortalama yaşları 42,7±44,2 ay (1 ay-16 yaş) idi. Tüm kültürlerde en sık üreyen bakteri %58,4 ile Escherichia Coli (E. coli) idi. Profilaksi alan ve almayan gruplar arasında kültürde üreyen bakterilerin dağılımı açısından bir fark saptanmadı. Kızlardaki idrar kültürlerinde E. coli görülme oranı erkeklerden daha...

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Antibiotic resistance of urinary tract pathogens and rationale for empirical intravenous therapy

Cited by 73 publications

References 22 publications

Antibiotic sensitivity and resistance in children with urinary tract infection in Sanliurfa

Antibiotic sensitivity and resistance in children with urinary tract infection in Sanliurfa

Increasing antibiotic resistance among uropathogens isolated during years 2006-2009: impact on the empirical management

Effect of Prophylactic Antibiotic Use in the Development of Antibiotic Resistance in Children with Recurrent Urinary Tract Infections

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