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[Uropathogen pattern and antimicrobial susceptibility in positive urinary cultures isolates from paediatric patients]
V Moya-Dionisio1, M Díaz-Zabala, A Ibáñez-Fernández
1Vanessa Moya-Dionisio, Área de Gestión Clínica de Pediatría. Hospital Universitario Central de Asturias, Oviedo, Spain. vanemd@hotmail.es.
Insights
Pediatric urinary tract infections show consistent uropathogen patterns, with Escherichia coli remaining most common. Current empirical antibiotic therapy recommendations are still applicable due to stable antimicrobial susceptibility.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance
- Clinical microbiology
Background:
- Urinary tract infections (UTIs) are common in children.
- Knowledge of local uropathogens and antibiotic susceptibility is crucial for effective empirical treatment.
Purpose of the Study:
- To analyze the bacterial patterns and antimicrobial susceptibility of urinary isolates in pediatric patients.
- To compare current findings with historical data to inform empirical UTI treatment strategies.
Main Methods:
- Retrospective analysis of 2,762 positive urinary isolates from pediatric patients (2009-2013).
- Comparison with a prior study from the same region (1995-1999).
Main Results:
- Escherichia coli was the predominant uropathogen (58.9%).
- High susceptibility of non-ESBL E. coli to nitrofurantoin, fosfomycin, cefotaxime, and aminoglycosides.
- Significant resistance of E. coli to ampicillin (56%), oral first-generation cephalosporins (49%), and trimethoprim-sulfamethoxazole (22%).
- Ampicillin and amoxicillin-clavulanate showed effectiveness against Enterococcus sp. and Proteus mirabilis, respectively.
- No significant changes in bacterial patterns or susceptibility were observed compared to the 1990s.
Conclusions:
- Escherichia coli remains the primary cause of pediatric UTIs.
- Antimicrobial susceptibility patterns have remained largely unchanged since the 1990s.
- Current recommendations for empirical antibiotic therapy in pediatric UTIs are still relevant.
Objective:
Knowledge of urophatogens and antibiotic susceptibility should be used to assist with empirical urinary tract infection treatment.
Methods:
We retrospectively analysed local bacterial pattern and antimicrobial susceptibility in positive urinary isolates from paediatric patients collected in the period 2009-2013. Results were compared with a previous study carried out in the same sanitary area between 1995 and 1999.
Results:
We identified 2,762 urinary isolates. Escherichia coli was the most common uropathogen (58.9%), followed by Enterococcus sp. (11.6%) and Proteus mirabilis (10.9%). More than 95% of non extended-spectrum beta-lactamase (ESBL)-producing E. coli were susceptible to nitrofurantoin, fosfomycin, cefotaxime and aminoglycosides. However, 56%, 49%, and 22% of the E. coli isolates were resistant to ampicillin, oral first-generation cephalosporins, and trimethoprim-sulfamethoxazole, respectively. Ampicillin and amoxicillin-clavulanate were the most effective antibiotics to treat Enterococcus sp. and P. mirabilis, respectively. Not significant modifications were found compared to results published at the same area in the 90´s.
Conclusions:
E. coli was the mostly isolated uropathogen, with a high percentage of resistance to ampicillin, oral first-generation cephalosporins, and trimethoprim-sulfamethoxazole. These urinary isolates and antimicrobial susceptibility patterns were similar to those reported in other paediatric studies and did not show significant changes compared to local previously published results. Thus, it can be considered that the current recommendations about empiric antibiotic therapy in paediatric urinary tract infections remain applicable nowadays.
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