Vélez Echeverri Catalina, Serna-Higuita Lina María, Serrano Ana Katherina, Ochoa-García Carolina, Rojas Rosas Luisa, María Bedoya Ana, Suárez Margarita, Hincapié Catalina, Henao Adriana, Ortiz Diana, Vanegas Juan José, Zuleta John Jairo, Espinal David
Pediatric Nephrologist, Hospital Pablo Tobón Uribe. Medellín Colombia.
Pediatric Nephrologist, Universidad de Antioquia. Medellín Colombia.
Colomb Med (Cali). 2014 Mar 30;45(1):39-44. eCollection 2014 Jan-Mar.
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.
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.
This is a descriptive, retrospective study.
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.
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.
尿路感染（UTI）是儿童时期最常见的细菌感染之一，可导致急慢性发病以及长期高血压和慢性肾脏病。
描述儿科人群尿路感染的人口统计学特征、感染病原体、抗生素耐药模式、病原体及药敏情况以及经验性治疗的反应。
这是一项描述性回顾性研究。
该研究纳入144例患者，男女比例为1:2.06。最常见症状为发热（79.9%），31.3%有既往尿路感染病史。72.0%的患者尿白细胞计数阳性（每视野>5个），85.0%的样本尿革兰氏染色阳性，分离出的总病原体中革兰氏阴性杆菌占77.8%。分离出的最常见尿路病原体是大肠埃希菌和肺炎克雷伯菌。我们分离的大肠埃希菌对大多数使用的抗生素敏感率高于90%，但对复方新诺明耐药率为42.6%，对氨苄西林舒巴坦耐药率为45.5%。6.3%的大肠埃希菌是产超广谱β-内酰胺酶菌株。最常用的经验性抗生素是阿米卡星，66.0%的患者使用过。90例行排尿性膀胱尿道造影（VCUG）的患者中有17例存在膀胱输尿管反流。
本研究表明大肠埃希菌是社区获得性尿路感染最常见的病原体。我们发现大肠埃希菌和其他尿路病原体对复方新诺明和氨苄西林舒巴坦耐药率较高。为确保经验性治疗成功，治疗方案应基于当地流行病学和药敏率制定。
