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Susceptibility patterns of uropathogens identified in hospitalized children

Ioanna Kalaitzidou1, Fani Ladomenou1, Emmanouil Athanasopoulos1

  • 1Department of Pediatrics, Venizeleion General Hospital, Heraklion, Crete, Greece.

Pediatrics International : Official Journal of the Japan Pediatric Society
|December 30, 2018
PubMed

Insights

Community-acquired febrile urinary tract infections (UTIs) in children are common. Escherichia coli is the leading cause, with high resistance to ampicillin and amoxicillin-clavulanic acid, suggesting these are not ideal empirical treatments.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Urinary tract infections (UTIs) represent a significant bacterial infection in pediatric populations.
  • Community-acquired febrile UTIs in children necessitate understanding causative agents and resistance patterns.

Purpose of the Study:

  • To identify common uropathogens in pediatric community-acquired febrile UTIs.
  • To assess antibiotic susceptibility of these uropathogens.
  • To determine risk factors associated with antibiotic resistance.

Main Methods:

  • A 5-year retrospective study of 284 children hospitalized with community-acquired UTIs in southern Greece.
  • Analysis of uropathogen identification and antibiotic susceptibility testing.
  • Statistical analysis to identify risk factors for multidrug resistance (MDR).

Main Results:

  • Escherichia coli was the predominant uropathogen (70-80%), followed by Klebsiella spp. and Proteus spp.
  • High resistance rates were observed for E. coli against ampicillin (41.8%), piperacillin (40.3%), and amoxicillin-clavulanic acid (28.6%).
  • Vesicoureteral reflux was identified as a significant risk factor for MDR (P = 0.04). Parenteral cephalosporins (cefuroxime, cefotaxime) showed high efficacy (>95% susceptibility).

Conclusions:

  • Amoxicillin/clavulanic acid may not be the optimal choice for empirical treatment of community-acquired UTIs in this region.
  • Second- and third-generation cephalosporins demonstrate sustained activity against common uropathogens.
  • Understanding local resistance patterns is crucial for effective empirical antibiotic therapy in pediatric UTIs.
Abstract

Keywords:
antibiotic susceptibilitychildrenmulti-drug resistanceurinary tract infectionuropathogen

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