Antimicrobial resistance of pathogens in hospitalized children with urinary tract infection in Greece
Abstract number: P1488
Konstantopoulou S., Daniil I., Petraki I., Nikolarou E., Balampani E., Ntoska P., Papageorgiou D., Charalampidou A., Petropoulou D.
Objectives: The manifestation of urinary tract infection (UTI) in children tends to be nonspecific, so the culture of urine collected appropriately is the method of choice for the diagnosis and management of UTI, especially in infants and young children. Moreover, UTIs are among the most common infections with an increasing resistance to antimicrobials worldwide. The aim of this study was to indentify the causative pathogens in children hospitalized for community acquired febrile UTI in a tertiary hospital in Greece and to investigate their resistance to common antibiotics.
Methods: During three-years period (20072009), we studied a total of 117 urine culture specimens from children (65% female and 35% male, aged 0.08 to 13 years) hospitalized with symptoms and signs of UTI. Transurethral catheterization or bladder tap was the urine collection method in children <2 years old, while clean voided midstream urine specimens collected from older children. The urine specimens were examined by Gram stain and culture in appropriate media (blood agar and McConkey agar) for detection of uropathogens. Any isolated pathogen (after 2448 hours incubation) was identified using BBL Enterotube II (BD Diagnostic Systems, Germany), Api System and Vitek 2 Compact (Biomerieux, France). Disk diffusion agar method was used according to the current CLSI guidelines for the antibiotic susceptibility test of isolated uropathogens.
Results: The most frequent UTI pathogens detected in children enrolled in the study were: E. coli (73.4%), Klebsiella spp. (8.9%), P. mirabilis (8.1%), E. faecalis (3.2%) and Pseudomonas spp. (1.6%). Antimicrobial resistance of E. coli isolates to commonly used antibiotics was: ampicillin 67%, trimethoprim-sulfamethoxazole (TMP-SMX) 27.3%, cefuroxime 11% and gentamicin 7.7%. Resistance to ampicillin, TMP-SMX, cefuroxime and gentamicin was noted for 67%, 31.5%, 12.1% and 8.1% of the total uropathogens, respectively.
Conclusion:Escherichia coli was the most prevalent pathogen in children hospitalized with UTI. Several of the first-line agents for empirical treatment of childhood UTI seem to have become ineffective, mainly ampicillin and TMP-SMX. Staining and culture examination of urine samples and antibiotic susceptibility test of detected uropathogens, along with the clinical information available at diagnosis, can help in treatment selection.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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