Resistance profile for pathogens causing urinary tract infection in a pediatric population, and antibiotic treatment response, at a university hospital 2010-2011

Abstract

Background: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood and causes acute and chronic morbidity as hypertension and chronic kidney disease. Objectives: To describe the demographic characteristics, infectious agent, antibiotic resistance patterns and empiric therapy response of UTI in pediatric population. Methods: This is a descriptive, retrospective study. Results: Were included 144 patients, 1:2.06 male to female ratio. The most common symptom was fever (79.9%) and 31.3% had history of previous UTI. 72.0% of the patients had positive urine leukocyte count (>5 per field), urine gram was positive in 85.0% of samples and gram negative bacilli accounted for 77.8% for the total pathogens isolated. The most frequent uropathogens isolated were Escherichia coli and Klebsiella pneumoniae. Our E.coli isolates had a susceptibility rate higher than 90% to most of the antibiotics used, but a resistance rate of 42.6% to TMP SMX and 45.5% to ampicillin sulbactam. 6.3% of E. coli was extended-spectrum beta-lactamases producer strains. The most frequent empirical antibiotic used was amikacin, used in 66.0% of the patients. 17 of 90 patients who undergone voiding cistouretrography (VCUG) had vesicoureteral reflux. Conclusion: This study revealed that E. coli was the most frequent pathogen of community acquired UTI. We found that E. coli and other uropathogens had a high resistance rate against TMP SMX and ampicillin sulbactam. In order to ensure a successful empirical treatment, protocols should be based on local epidemiology and susceptibility rates. ResumenAntecedentes: La infección del tracto urinario (ITU) es una de las infecciones bacterianas más frecuentes en la infancia, se asocia con alta morbilidad aguda y de enfermedades a largo plazo como hipertensión arterial e insuficiencia renal crónica. Objetivo: Describir las características demográficas, agente etiológico, perfil de sensibilidad y respuesta al tratamiento empírico de una población pediátrica. Métodos: Estudio descriptivo, retrospectivo realizado en el Hospital Pablo Tobón Uribe (HPTU), Medellín (Colombia), entre enero de 2010 y diciembre de 2011. Resultados: Se incluyeron 144 pacientes, con una relación hombre: mujer de 1:2.06. El 79.9% consultó por fiebre objetiva y el 31.3% había tenido un episodio de ITU previa. El 72.0% presentó leucocituria y el gram de gota de orina sin centrifugar fue positivo en el 86.0% (77.8% de bacilos con tinción de gram negativos). Los uropatógenos más frecuentes fueron Escherichia coli y Klebsiella pneumoniae. Escherichia coli tuvo una sensibilidad mayor al 90% para la mayoría de antibióticos, excepto en el de trimetropín sulfametoxazol, con una resistencia del 42.6% y del 45.5% a la ampicilina sulbactam. Se usó la amikacina como tratamiento empírico en el 66.0%. En 17 de 90 pacientes se encontró algún grado de reflujo vesicoureteral (RVU). Conclusión: La elección del tratamiento empírico precoz debe basarse en el conocimiento de la epidemiología y el perfil de sensibilidad y resistencia...

Clinical risk factors, bacterial aetiology, and outcome of urinary tract infection in children hospitalized with diarrhoea in Bangladesh

“…UTI in febrile children has been widely studied in different parts of the world [13,14,21]. An 11% prevalence in febrile children aged <5 years was reported by researchers in Nigeria [21].…”

“…Of these pathogens E. coli is the most common responsible for UTI [12]. Studies from Ethiopia and Colombia suggest that antibiotic resistance of urinary tract pathogens is known to increase worldwide, especially to commonly used antimicrobials [13,14]. The increasing antibiotic resistance trends are likely to have important clinical implications for the empirical use of antibiotics [15].…”

Pediatric urinary tract infection as a cause of outpatient clinic visits in southern Ethiopia: a cross sectional study

“…Urinary Tract Infection (UTI) is the most common childhood bacterial infection associated with high morbidity and long-term complications like renal scarring, hypertension, and chronic renal failure ( 1 ). To reduce the adulthood complications, early diagnosis, proper investigation, adequate therapy and prolonged follow-up are of outmost importance.…”

“…Gram negative enteric bacilli such as Escherichia coli, Klebsiella ssp., Proteus ssp., Enterobacter ssp., Pseudomonas ssp., and Citrobacter spp. and Gram-positive organisms, including group B streptococci, Enterococcus spp, and Staphylococcus aureus are commonly associated with pediatric UTI ( 1 , 4 , 5 ).…”

Bacterial and Fungal Pathogens in the Transplantation and Dialysis Center. Analysis for Eighteen Years (1998–2015)

“…Инфекции мочевых путей являются одним из самых частых инфекционных осложнений у больных с хронической болезнью почек. Как правило, возбудителями являются кишечная палочка, клебсиелла и стафилококки [9][10][11]. Однако проведенный нами ранее анализ показал несколько иные результаты [12].…”