소아 요로 감염에서 Escherichia coli에 대한 항생제 감수성의 변화에 대한 연구

Escherichia coli Susceptibility to Antimicrobials in Children with Urinary Tract Infection

Purpose : This study was performed to identify longitudinal changes in the prevalence of organisms isolated from urinary tract infection(UTI) and in the pattern of Escherichia coli susceptibility to antibiotics during the past 10 years in children with UTI. Methods : We performed a retrospective study of a total of 192 urine cultures from children with UTI in the Department of Pediatrics, Seoul Adventist Hospital over two periods(1st: 1995-2000, 2nd:2001-2005). Antimicrobial susceptibility of the isolates was compared between the two groups. Results : The pathogens of UTI in the two groups were similar. In the first period, E. coli was the leading uropathogen(66.2%) followed by Klebsiella pneumoniae(7.8%), Enterobacter cloacae(6.5%), and others(19.5%). In the second period, E. coli was the leading uropathogen(67%) followed by K. pneumoniae(12.2%), E. cloacae(3.5%), Enterobacter aerogenes(3.5%), and others(13.8%). The susceptibility pattern of E. coli to amoxicillin/clavulanate(87.5%, 81.0%) did not present any statistically significant difference between the two periods(P>0.05). The susceptibility of E. coli to TMP/SMX(52.4%, 50.0%) was still low with no significant difference between the two periods(P>0.05). Conclusion : Our results suggest that the use of amoxicillin/clavulanate is still an excellent therapeutic option in children with UTI. The low rate of susceptibility to TMP/SMX against uropathogens suggest that TMP/SMX may be reevaluated as the first-line therapeutic drug for UTI.