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Antibiotic Resistance Patterns of Escherichia coli and Non-Escherichia coli Gram Negative Uropathogens in Pediatric Urinary Tract Infections for the Years 2001-2008
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Jun-mo Kim, Hee-bong Shin, Kwang-Woo Lee, Young-Ho Kim, Min-Eui Kim
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Korean J Urogenit Tract Infect Inflamm 2009;4(2):210-219. Published online October 31, 2009
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 Abstract
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- "Purpose: Because many gram negative bacterial species among the members of the Enterobacteriaceae are implicated hospital acquired infection including catheter-associated infection, antimicrobial resistance between Escherichia coli (E. coli) and other gram negative uropathogens could be different. We evaluated the epidemiologic data and antibiotic resistance patterns of E. coli and other gram negative uropathogens. Materials and Methods: Between February 2001 and November 2008, we retrospectively analyzed positive urine samples of 618 pediatric patients under 15 years of age with the first urinary tract infection (UTI) by E. coli and 419 other gram negative uropathogens. Mean age was 1.0±2.4 years. We compared antibiotic resistnace rate according to E. coli and non-E. coli group, each gram negative bacteria, age group, gender, and early and late period. Results: Although resistance rate of E. coli to ciprofloxacin (9.7%) and co-trimoxazole (34.1%) is higher than non-E. coli gram negative uropathogen (2.4%, 21.5%), resistance rate of non-E. coli gram negative uropathogen to ampicillin (90.9%), amoxicillin-clavulanic acid (52.0%), 1st to 3rd generation cephalosporins (65.2% to 23.6%), and imipenem (2.6%) is higher than E. coli. The resistance rate to co-trimoxazole of age group of 1-15 years is higher than age group of less than 1 year in both E. coli (44.0% Vs 30.4%) and non-E. coli gram negative uropathogens (28.0% Vs 18.9%). In comparison between early and late period, resistance rate to 3rd generation cephalosporin (32.9% Vs 17.6%) and gentamicin (36.0% Vs 16.1%) was decreased. Conclusions: The resistance rate of gram negative uropathogens other than E. coli to ampicillin, cephalosporins, and imipenem was higher than E. coli. Because our result shows resistance rate to amikacin is low in all of gram negative uropathogen including E. coli, it could be reasonable choice in the empirical treatment of the first UTI in children."
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Antibiotic Resistance Patterns of Escherichia coli in Pediatric Urinary Tract Infections for 8 Years from 2001 to 2008
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Jae-I Koh, Jun-Mo Kim, Hee-Bong Shin, Min-Eui Kim
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Korean J Urogenit Tract Infect Inflamm 2009;4(1):47-55. Published online April 30, 2009
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Abstract
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- "Purpose: Because the most common causative organism of the pediatric urinary tract infections (UTI) is Escherichia coli (E. coli), epidemiologic data and antibiotic resistance patterns of E. coli in several regions are important for empirical treatment in children with UTI. Materials and Methods: Between February 2001 and November 2008, we retrospectively analyzed positive urine samples of 618 pediatric patients under 15 years of age with the first UTI by E. coli. Mean age was 1.12±2.5 years. We divided the period into early (2001-2004, 217 patients) and late (2005-2008, 401 patients), and analyzed resistance patterns in two age groups: group 1, ≤ 12 months and group 2, 1-15 years. Results: Although resistance to ampicillin (75.1%), co-trimoxazole (34.1%), gentamycin (25.2%), cephalothin (21.5%) was significant resistance against amikacin (0.8%), cefoxitin (3.9%), ciprofloxacin (9.7%), imipenem (0.3%) was less than 10%. Antibiotics resistance rates was significantly decreased from early to late period in gentamycin (35% to 20.0%), cephalothin (32.7% to 15.5%), cefotaxime (17.5% to 8.7%), and there was no antibiotics with increased resistance rates between the early and the late period. In comparison between group 1 and 2, resistance to ampicillin (71.3% Vs 85.1%), amoxacillin-clavulanic acid (7.6% Vs 17.9%), cephalothin (19.1% Vs 28.0%), and co-trimoxazole (30.4% Vs 44.0%) was significantly increased with age. Conclusions: Although the resistance rates of E. coli to commonly used antimicrobial agents like as ampicillin, co-trimoxazole, gentamycin, first-generation cephalosporins was high in children with UTI, there was a trend toward decreasing resistance in our region. Amoxacillin-clavulanic acid, second-generation cephalosporins, amikacin could be reasonable alternative in the empirical treatment of the first UTI in children."
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