Isac Raluca, Doros Gabriela, Stolojanu Cristiana-Alexandra, Steflea Ruxandra Maria, Stroescu Ramona Florina, Olariu Ioana-Cristina, Micsescu-Olah Andrada-Mara, Gafencu Mihai
Department of Pediatrics, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Emergency Hospital for Children "Louis Turcanu", Iosif Nemoianu Street 2, 300011 Timisoara, Romania.
Antibiotics (Basel). 2024 Jul 24;13(8):684. doi: 10.3390/antibiotics13080684.
Urinary tract infection (UTI) represents one of the most common bacterial infections in children, mainly caused by Gram-negative bacteria. Empirical antibiotic treatment is based on international and national guidelines for treating UTIs in children and is individualized with local antibiotic resistance patterns. The aim of this study is to bring a clear view of present-day particularities of UTIs in children.
We analyzed 210 positive urine cultures identified in 141 pediatric patients admitted to the hospital over a 6-month period.
The majority of patients were females (57%) with a median age of 5 years (IQR 12), while male patients revealed a median age of 2 (IQR 7). Most patients originated from urban areas (53%). Only 18 patients (12.76%) were identified with underlying Congenital Anomalies of the Kidney and Urinary Tract (CAKUT). Escherichia Coli was the most frequent pathogen. Increased antibiotic resistance was found in commonly-used antibiotics Ampicillin and Trimethoprim/Sulfamethoxazole, and in the case of patients with CAKUT. Suitable antibiotics for treating a Gram-negative UTI are aminoglycosides, Meropenem, third-generation Cephalosporins, and Nitrofurantoin. Vancomycin upholds efficacy in treating a Gram-positive pediatric UTI.
Periodical analysis needs to be performed in order to constantly update clinicians on uropathogenic antibiotic resistance and optimal empirical treatment options.
尿路感染（UTI）是儿童最常见的细菌感染之一，主要由革兰氏阴性菌引起。经验性抗生素治疗基于国际和国家儿童UTI治疗指南，并根据当地抗生素耐药模式进行个体化治疗。本研究的目的是清晰呈现儿童UTI的当前特点。
我们分析了在6个月期间收治的141例儿科患者中鉴定出的210份阳性尿培养结果。
大多数患者为女性（57%），中位年龄为5岁（四分位间距12），而男性患者的中位年龄为2岁（四分位间距7）。大多数患者来自城市地区（53%）。仅18例患者（12.76%）被鉴定为患有先天性肾脏和尿路异常（CAKUT）。大肠杆菌是最常见的病原体。在常用抗生素氨苄西林和甲氧苄啶/磺胺甲恶唑中以及CAKUT患者中发现抗生素耐药性增加。治疗革兰氏阴性UTI的合适抗生素是氨基糖苷类、美罗培南、第三代头孢菌素和呋喃妥因。万古霉素在治疗革兰氏阳性儿科UTI中保持疗效。
需要定期进行分析，以便不断向临床医生更新尿路致病性抗生素耐药性和最佳经验性治疗方案。
