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[Bacterial pathogens, resistance patterns and treatment options in community acquired pediatric urinary tract infection].
Klin Padiatr. 2004 Mar-Apr; 216(2):83-6.KP

Abstract

BACKGROUND

Epidemiology and resistance patterns of bacterial pathogens in pediatric UTI show large interregional variability and rates of bacterial resistances are changing due to different antibiotic treatment. We intended to evaluate data from northern Germany.

PATIENTS AND METHODS

In 100 children (53 female, 47 male, mean age 4.4 +/- 4.2 years) with community acquired UTI, who presented in the emergency department of our medical school from 2000 - 2002, urine cultures were performed. Inclusion criteria were: acute voiding symptoms, significant bacteriuria with growth of at least 10 (5) colony-forming units/ml urine, leukocyturia > 50/ micro l. Exclusion criteria were underlying renal diseases, anatomic abnormalities of the urinary tract, age < 2 months and recurrent UTI.

RESULTS

Patients presented with a mean rectal temperature of 38.6 +/- 1.3 degrees C, mean CRP of 66 +/- 68 mg/dl, mean WBC 13 500 +/- 5 600/ micro l and mean urinary leukocytes of 425 +/- 363/ micro l. In urine cultures E. coli was found in 47 % of the cases, Enterococcus faecalis 23 %, Proteus mirabilis 8 %, Klebsiella oxytoca 4 %, Pseudomonas aeruginosa 5 % and others 13 %. In 76 % one and in 24 % two different bacterial species (60 % Enterococcus faecalis) were cultured. Mean resistance rates were in all bacteria (in E. coli): Ampicillin 53 % (69 %), Ampicillin and Sulbactam 51 % (61 %), Cefalosporin 1 (st) generation (Cefaclor) 48 % (24 %), Cefalosporin 2 (nd) generation (Cefuroxim) 40 % (3 %), Cefalosporin 3 (rd) generation (Cefuroxim) 33 % (0 %), Tobramycin 30 % (2 %), Ciprofloxacine 0 %, Cotrimoxazole 40 % (42 %), Nitrofurantoin 12 % (0 %).

CONCLUSION

The resistance rates to Ampicillin (+/- Sulbactam) did not increase as compared to previous analyses (1990 - 1995), however, resistance rates to Cotrimoxazole and 1 (st) generation Cefalosporines increased about 20 %. We conclude that the policies for treatment of UTI in children should be re-evaluated every 5 years according to local resistance rates.

Authors+Show Affiliations

Pape L
Abteilung für pädiatrische Nephrologie und Stoffwechselerkrankungen, Medizinische Hochschule Hannover.
Gunzer F
No affiliation info available
Ziesing S
No affiliation info available
Pape A
No affiliation info available
Offner G
No affiliation info available
Ehrich JH
No affiliation info available

MeSH

Anti-Infective Agents, UrinaryBacterial InfectionsBacteriuriaChildChild, PreschoolCommunity-Acquired InfectionsCross-Sectional StudiesDrug Resistance, MultipleEnterococcus faecalisEscherichia coliEscherichia coli InfectionsFemaleGermanyGram-Positive Bacterial InfectionsHumansIncidenceInfantKlebsiella InfectionsKlebsiella oxytocaMaleMicrobial Sensitivity TestsProteus InfectionsProteus mirabilisPseudomonas InfectionsPseudomonas aeruginosaUrinary Tract Infections

Pub Type(s)

Journal Article

Language

ger

PubMed ID

15106080

Citation

Pape, L, et al. "[Bacterial Pathogens, Resistance Patterns and Treatment Options in Community Acquired Pediatric Urinary Tract Infection]." Klinische Padiatrie, vol. 216, no. 2, 2004, pp. 83-6.
Pape L, Gunzer F, Ziesing S, et al. [Bacterial pathogens, resistance patterns and treatment options in community acquired pediatric urinary tract infection]. Klin Padiatr. 2004;216(2):83-6.
Pape, L., Gunzer, F., Ziesing, S., Pape, A., Offner, G., & Ehrich, J. H. (2004). [Bacterial pathogens, resistance patterns and treatment options in community acquired pediatric urinary tract infection]. Klinische Padiatrie, 216(2), 83-6.
Pape L, et al. [Bacterial Pathogens, Resistance Patterns and Treatment Options in Community Acquired Pediatric Urinary Tract Infection]. Klin Padiatr. 2004 Mar-Apr;216(2):83-6. PubMed PMID: 15106080.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Bacterial pathogens, resistance patterns and treatment options in community acquired pediatric urinary tract infection]. AU - Pape,L, AU - Gunzer,F, AU - Ziesing,S, AU - Pape,A, AU - Offner,G, AU - Ehrich,J H, PY - 2004/4/24/pubmed PY - 2004/9/9/medline PY - 2004/4/24/entrez SP - 83 EP - 6 JF - Klinische Padiatrie JO - Klin Padiatr VL - 216 IS - 2 N2 - BACKGROUND: Epidemiology and resistance patterns of bacterial pathogens in pediatric UTI show large interregional variability and rates of bacterial resistances are changing due to different antibiotic treatment. We intended to evaluate data from northern Germany. PATIENTS AND METHODS: In 100 children (53 female, 47 male, mean age 4.4 +/- 4.2 years) with community acquired UTI, who presented in the emergency department of our medical school from 2000 - 2002, urine cultures were performed. Inclusion criteria were: acute voiding symptoms, significant bacteriuria with growth of at least 10 (5) colony-forming units/ml urine, leukocyturia > 50/ micro l. Exclusion criteria were underlying renal diseases, anatomic abnormalities of the urinary tract, age < 2 months and recurrent UTI. RESULTS: Patients presented with a mean rectal temperature of 38.6 +/- 1.3 degrees C, mean CRP of 66 +/- 68 mg/dl, mean WBC 13 500 +/- 5 600/ micro l and mean urinary leukocytes of 425 +/- 363/ micro l. In urine cultures E. coli was found in 47 % of the cases, Enterococcus faecalis 23 %, Proteus mirabilis 8 %, Klebsiella oxytoca 4 %, Pseudomonas aeruginosa 5 % and others 13 %. In 76 % one and in 24 % two different bacterial species (60 % Enterococcus faecalis) were cultured. Mean resistance rates were in all bacteria (in E. coli): Ampicillin 53 % (69 %), Ampicillin and Sulbactam 51 % (61 %), Cefalosporin 1 (st) generation (Cefaclor) 48 % (24 %), Cefalosporin 2 (nd) generation (Cefuroxim) 40 % (3 %), Cefalosporin 3 (rd) generation (Cefuroxim) 33 % (0 %), Tobramycin 30 % (2 %), Ciprofloxacine 0 %, Cotrimoxazole 40 % (42 %), Nitrofurantoin 12 % (0 %). CONCLUSION: The resistance rates to Ampicillin (+/- Sulbactam) did not increase as compared to previous analyses (1990 - 1995), however, resistance rates to Cotrimoxazole and 1 (st) generation Cefalosporines increased about 20 %. We conclude that the policies for treatment of UTI in children should be re-evaluated every 5 years according to local resistance rates. SN - 0300-8630 UR - https://www.unboundmedicine.com/medline/citation/15106080/[Bacterial_pathogens_resistance_patterns_and_treatment_options_in_community_acquired_pediatric_urinary_tract_infection]_ DB - PRIME DP - Unbound Medicine ER -