INTRODUCTION: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood and causes acute and chronic morbidity and long-term hypertension and chronic kidney disease.
OBJECTIVES: To describe the demographic characteristics, infectious agents, patterns of antibiotic resistance, etiologic agent and profile of susceptibility and response to empirical treatment of UTI in a pediatric population.
METHODS: This is a descriptive, retrospective study.
RESULTS: Included in the study were 144 patients, 1:2.06 male to female ratio. The most common symptom was fever (79.9%) and 31.3% had a 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, which was used in 66.0% of the patients. 17 of 90 patients who underwent 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.
Written by:
Vélez Echeverri C, Serna-Higuita LM, Serrano AK, Ochoa-García C, Rojas Rosas L, María Bedoya A, Suárez M, Hincapié C, Henao A, Ortiz D, Vanegas JJ, Zuleta JJ, Espinal D. Are you the author?
Pediatric Nephrologist, Hospital Pablo Tobón Uribe, Medellín Colombia; Pediatric Nephrologist, Universidad de Antioquia, Medellín Colombia; Medical Laboratory Technician, Hospital Pablo Tobón Uribe, Medellín Colombia; Pediatrician, Hospital Pablo Tobón Uribe, Medellín Colombia; Clinical Epidemiologist, Hospital Pablo Tobón Uribe, Medellín Colombia.
Reference: Colomb Med (Cali). 2014 Mar 30;45(1):39-44.
PubMed Abstract
PMID: 24970958