Antimicrobial Resistance of Uropathogens in Children with Febrile Urinary Tract Infections


Authors: G. Koľvek 1;  Ľ. Podracká 1;  K. Čurová 2;  L. Siegfried 2
Authors‘ workplace: I. Klinika detí a dorastu UPJŠ LF a DFN, Košice prednostka prof. MUDr. Ľ. Podracká, CSc. 1;  Ústav lekárskej mikrobiológie a klinickej mikrobiológie UPJŠ LF, Košice prednosta prof. MUDr. L. Siegfried, CSc. 2
Published in: Čes-slov Pediat 2009; 64 (9): 392-399.
Category: Original Papers

Overview

Febrile urinary tract infections belong to the most common bacterial infections in childhood. Renal scaring could develop as a consequence of severe infection therefore an early diagnose and suitable empiric antibiotic treatment is mandatory. Choice of antibiotic is based on the epidemiologic data as well as surveillance of antimicrobial resistance patterns of common uropathogens.

The aim of the retrospective study was to analyze bacterias isolated from 68 children with febrile urinary tract infections (UTI) and to asses the efficacy of antibiotic treatment. Obtained results were evaluated according to the child’s age and occurrence of congenital urinary tract (UT) anomalies. Escherichia coli (E. coli) was the leading uropathogen (56 children, 82.4%) in all groups of children. Patients with congenital UT anomalies showed both significantly higher proportion of non-Escherichia coli (non-E. coli) infections (p<0.033) and antibiotic resistance (CIP 18.8% vs. 2.8%, p<0.025; CTX 21.9% vs. 5.6 %, p<0.047), also the tendency of higher resistance especially to COT (46.9% vs.19.4%, p<0.024) and GEN (28.1% vs. 0%, p<0.001) was present compared to children without anomalies. In E. coli group without congenital UT anomalies antibiotic resistance was minimal (GEN 0%, CTX 3.0% a CIP 0%) except for COT (18.2%) and AMP (28.1%).

Conclusions:
Our data support that empirical therapy of febrile UTI with cephalosporins of third generation and aminoglycosides is suitable, since bacterial strains shows good susceptibility to the both antibiotics. Patients with congenital UT anomalies have more common non-E. coli infections and higher resistance patterns against antimicrobial agents as well.

Key words:
acute pyelonephritis, antibiotic resistance, congenital urinary tract anomalies


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Neonatology Paediatrics General practitioner for children and adolescents
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