ESPN 50th Annual Meeting

ESPN 2017


 
MULTIDRUG RESISTANT BACTERIA IN CHILDREN WITH URINARY TRACT INFECTIONS AND THEIR MANAGEMENT
NATAšA MARčUN VARDA 1

1- UNIVERSITY MEDICAL CENTRE MARIBOR, DEPARTMENT OF PAEDIATRICS
 
Introduction:

In recent years multidrug resistant bacteria has become increasingly recognised as a cause of urinary tract infections (UTI) in children. The aim of our study was to find out the spectrum of bacteria identified in our children with UTI in the last year, including multidrug resistant ones, and to compare it with the study performed in the period from 2011 to 2013. In addition, we were interested in antibiotic treatment.

 

Material and methods:

103 children, hospitalized at our Nephrology Unit in 2016 with culture confirmed UTI, were included in the study in retrospective manner. Medical documentation was examined and some clinical data, results of urine culture, diagnostics and treatment were collected and compared with the results of similar study performed during the period 2011-2013. 

 

Results:

There were 25 boys (24.3%) and  78 girls (75.7%) included in the study. In 9.7% congenital anomaly was present before admission which is less than in the period 2011-2013. In 97% of children US of kidney was performed and in 26.2% further diagnostic procedure has been indicated.  E. coli was the most common pathogen found in 80.5% of children (before 78.4%), in 47.0% sensitive to all tested antibiotics (before 48.9%). Resistance to ampicillin was present in 48.2%, trimethoprim-sulfamethoxazole in 18.1%, amoxicillin-clavulanate in 9.6%, quinolones in 7.2%, gentamicin in 4.8%, which is similar to the previous study. Multidrug resistant  bacteria were found in 4.9% (before 5.5%). Children were treated with gentamicin in 69.9%, amoxicillin-clavulanate in 17.5%, cephalosporins in 3.9%, similar to the period 2011-2013 . Reserve antibiotics were prescribed only in 1.9% cases (before 2.3%). Treatment protocol was changed in 9.7% (before 6.4%).

 

Conclusions:

E. coli remains the leading uropathogen in our children with UTI, with similar resistant patterns and treatment. Multidrug resistant bacteria have not increased and the prescription of reserved antibiotics was rarely needed.