Konca Capan, Tekin Mehmet, Uckardes Fatih, Akgun Sadik, Almis Habip, Bucak Ibrahim Hakan, Genc Yeliz, Turgut Mehmet
Division of Pediatric Intensive Care Unit, School of Medicine, Adiyaman University, Adiyaman, Turkey.
Department of Pediatrics, School of Medicine, Adiyaman University, Adiyaman, Turkey.
Pediatr Int. 2017 Mar;59(3):309-315. doi: 10.1111/ped.13139. Epub 2016 Nov 6.
Urinary tract infection (UTI) is common in children. The aim of this study was therefor to construct a guide for the empirical antibiotic treatment of community-acquired UTI by investigating the etiology and antimicrobial resistance patterns of uropathogens and analyzing the epidemiological and clinical patient characteristics.
A total of 158 children with positive urine culture were included in the study. Antibiotic susceptibility testing was performed with Vitek 2 Compact for 28 commonly used antimicrobials.
Mean age was 3.36 ± 3.38 years (range, 45 days-15 years). Escherichia coli (60.1%), and Klebsiella spp. (16.5%) were the most common uropathogens. For all Gram-negative isolates, a high level of resistance was found against ampicillin/sulbactam (60.1%), trimethoprim/sulfamethoxazole (44.2%), cefazolin (36.2%), cefuroxime sodium (33.5%), and amoxicillin/clavulanate (31.5%). A low level of resistance was noted against cefepime (8.7%), ertapenem (4.6%), norfloxacin (1.3%), and meropenem (0.7%). There was no resistance against amikacin.
There is high antibiotic resistance in children with UTI. The patterns of uropathogen antimicrobial resistance vary in susceptibility to antimicrobials depending on region and time. Thus, the trends of antibiotic susceptibility patterns should be analyzed periodically to select the appropriate regimen for UTI treatment.
尿路感染(UTI)在儿童中很常见。因此,本研究的目的是通过调查尿路病原体的病因和抗菌药物耐药模式,并分析流行病学和临床患者特征,构建社区获得性UTI经验性抗生素治疗指南。
本研究共纳入158例尿培养阳性的儿童。使用Vitek 2 Compact对28种常用抗菌药物进行药敏试验。
平均年龄为3.36±3.38岁(范围为45天至15岁)。大肠埃希菌(60.1%)和克雷伯菌属(16.5%)是最常见的尿路病原体。对于所有革兰氏阴性菌分离株,发现对氨苄西林/舒巴坦(60.1%)、甲氧苄啶/磺胺甲恶唑(44.2%)、头孢唑林(36.2%)、头孢呋辛钠(33.5%)和阿莫西林/克拉维酸(31.5%)的耐药率较高。对头孢吡肟(8.7%)、厄他培南(4.6%)、诺氟沙星(1.3%)和美罗培南(0.7%)的耐药率较低。对阿米卡星无耐药。
UTI患儿存在较高的抗生素耐药性。尿路病原体的抗菌药物耐药模式在不同地区和时间对抗菌药物的敏感性有所不同。因此,应定期分析抗生素药敏模式的趋势,以选择合适的UTI治疗方案。