Abstract

"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."

• Keywords: Urinary tract infection, Antibiotic resistance, Escherichia coli