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[Profile of antimicrobial resistance of agents causing urinary tract infections in Chilean children. PRONARES

V Prado1, O Trucco, C Durán

  • 1Programa de Microbiología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago de Chile. vprado@machi.med.uchile.cl

Revista Medica De Chile
|October 30, 2001
PubMed

Insights

Antimicrobial resistance in pediatric urinary tract infections is significant, especially for E. coli and Klebsiella spp. Current E. coli treatment guidelines are mostly relevant, but caution is advised with first-generation cephalosporins.

Area of Science:

  • Pediatric infectious diseases
  • Antimicrobial resistance surveillance
  • Clinical microbiology

Background:

  • The National Surveillance Program for Antimicrobial Resistance (PRONARES) monitors antimicrobial susceptibility, including urinary tract infections (UTIs).
  • Data is collected through a laboratory network using standardized protocols and analyzed centrally with WHONET software.

Purpose of the Study:

  • To analyze the antimicrobial susceptibility patterns of pathogens causing UTIs in children between 1997 and 1999.
  • To inform treatment guidelines for pediatric UTIs based on local resistance data.

Main Methods:

  • Analysis of 5,525 bacterial strains, with 2,307 isolated from pediatric patients (hospitalized and ambulatory).
  • Data collected through the PRONARES national surveillance program.

Main Results:

  • Escherichia coli was the predominant pathogen (74.2%), showing high resistance to ampicillin (74%), clotrimoxazole (52%), and first-generation cephalosporins (30%).
  • E. coli remained sensitive to newer cephalosporins, aminoglycosides, ciprofloxacin, and nitrofurantoin.
  • Klebsiella spp. (8.2%) exhibited high resistance (>40%), particularly in nosocomial infections, but remained susceptible to ciprofloxacin (90%) and imipenem (100%).
  • Antimicrobial susceptibility patterns were generally consistent across different centers, with one pediatric center showing notably higher resistance levels.

Conclusions:

  • Current therapeutic recommendations for E. coli UTIs in children are largely appropriate, but cautious use of first-generation cephalosporins is recommended.
  • Treatment of Klebsiella spp. UTIs necessitates individualized antibiogram testing due to high resistance rates.
Abstract

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