| Microbiological spectrum and antibiotic susceptibility pattern in more than 24-month-old
children with urinary tract infection: A6-year retrospective, single center experience |
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Jeong Hee Ko1, Jee Hyung Lee1, Eun Jung Shim1, Do jun Cho1, Ki Sik Min1, Ki Yang Yoo1, Dae Young Lee1, Hee Jung Kang2 |
1Departments of Pediatrics, College of Medicine, Hallym University, Seoul, Korea
2Departments of Laboratory Medicine, College of Medicine, Hallym University, Seoul, Korea |
| 24개월 이상 소아에서 요로 감염의 원인균과 항생제 감수성의 양상 : 6년간 단일 기관 경험 |
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고정희1, 이지현1, 심은정1, 조도준1, 민기식1, 유기양1, 이대형1, 강희정2 |
1한림대학교 의과대학 소아과학교실
2한림대학교 의과대학 진단검사의학과학교실 |
Correspondence:
Dae Young Lee, Email: mdleedh@hallym.or.kr
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| Abstract |
Purpose
: To characterize the pathogens and their antibiotic susceptibilities in more than 24-month-old children with urinary tract infection (UTI) and to study the Escherichia coli antimicrobial susceptibility trend.
Methods
: We retrospectively reviewed the record of more than 24-month-old children with UTI between January 2003 and December 2008. Positive results for 1 bacterial species with a colony count of ≥105 CFU/mL was considered statistically significant. We analyzed uropathogens and their antibiotic susceptibilities. To investigate E. coli antibiotic susceptibility trend, we compared 2 study periods (group A: 2003-2005 versus group B: 2006-2008) using the chi-square test for trend.
Results
: In all, 63 bacterial isolates were identified in children with febrile UTI. The most common pathogen was E. coli (77.8%). There was no difference in the resistance patterns of uropathogens during the 2 study periods (P>0.05). Antibiotic susceptibility of the E. coli isolates to aztreonam, cefotetan, cefotaxime, ceftriaxone, cefepime, amikacin, and imipenem was >90% to trimethoprim/sulfamethoxazol, 49% and to ampicillin and ampicillin/sulbactam, 20-25%. Over the 2 study period, the E. coli susceptibilities to most antibiotics did not change: the susceptibility to cefuroxime increased from 74.1% to 95.5% (P=0.046) and that to ciprofloxacin increased from 59.3% to 86.4% (P=0.039).
Conclusion
: Empirical treatment with trimethoprim/sulfamethoxazole, ampicillin, and ampicillin/sulbactam alone appeared to be insufficient in childhood UTI because of the high resistance of E. coli and other gram-negative uropathogens. Antibiotics for empirical therapy should be selected based on the sensitivity and resistance pattern of uropathogens found in a particular region. |
| Key Words:
Urinary tract infection, Children, Antibiotic resistance |
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