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Changes in antimicrobial resistance and demographics of UTIs in pediatric patients in a single institution over a 6-year period

Journal of Pediatric Urology Jan 12, 2018

Erol B, et al. - This paper incorporated an identification of the variations in antimicrobial resistance and demographics of urinary tract infections (UTIs) in pediatric patients, over a 6-year period. When compared to males, the occurrence of UTI appeared to be nearly twice in females. It was determined that Escherichia coli (E. coli) was the most common pediatric uropathogen. Ampicillin, despite being widely used in other tract infections, was a poor empiric choice for pediatric UTIs. Findings revealed that cephalosporins were appropriate alternatives owing to their low resistance rates. Hence, researchers recommended that a successful empirical treatment protocol ought to be based on local epidemiology and susceptibility rates.

Methods

  • The outpatient urinary isolates from patients aged <18 years were inspected.
  • Between 2009-2014 a retrospective cross-sectional analysis was conducted of the bacteria isolated from children with UTI.
  • Researchers intended to identify the most common bacterial pathogens in the following four age groups: <2 years; 2-5 years; 6-12 years; and 13-17 years.
  • The prevalence and antibiotic resistance patterns for the six most common uropathogens were scrutinized: Escherichia coli, Proteus, Klebsiella, Enterobacter, Pseudomonas and Enterococcus.
  • Additionally, they assessed the antibiotic resistance pattern for UTI during 2009-2014.

Results

  • An evaluation was performed of 6,515 urinary cultures.
  • Maximum isolates were obtained from female patients (66.8%).
  • E. coli was determined to be the most common uropathogen overall.
  • However, its prevalence was found to be higher among females (79.5%) than males (54.9%).
  • The biggest percentage of isolates in males was obtained from children aged <2 years (46.1%).
  • In contrast, maximum isolates in females were yielded from children aged >6 years (46.8%).
  • Highest results of antimicrobial resistance for were reported for ampicillin (70%) and lowest for meropenem (0.19%).
  • The comparsison of hospital network data from 2009 to 2014 disclosed that E. coli resistance increased for ampicillin (from 47.1% to 89%), trimethoprim-sulfamethoxazole (TMP-SMX) (from 44.8% to 56%) and nitrofurantoin (from 5.3% to 15.1%).
  • On the other hand, maintenance of low antibiotic resistance was discovered in the case of cephalosporins.

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