Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Clinical Characteristics and Antibiotic Resistance of Urinary Tract Infections in Children: Escherichia. coli Versus Non-E. coli

소아 요로감염의 원인균주별 임상양상과 항생제 내성률 : 대장균과 비대장균의 비교

  • Bae, E-Young (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Soo-Young (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Jeong, Dae-Chul (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kang, Jin Han (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 배이영 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이수영 (가톨릭대학교 의과대학 소아과학교실) ;
  • 정대철 (가톨릭대학교 의과대학 소아과학교실) ;
  • 강진한 (가톨릭대학교 의과대학 소아과학교실)
  • Received : 2010.05.25
  • Accepted : 2010.07.14
  • Published : 2010.12.25
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Abstract

Purpose : We aimed to compare the clinical features and antibiotic resistance of urinary tract infection (UTI) caused by pathogens other than E. coli (non-E. coli) with UTI caused by E. coli in children. Methods : We enrolled patients with culture-proven UTI, who were admitted to the study hospital from September 2008 to August 2009. We investigated clinical data of patients with UTI and antibiotic resistance of isolated strains. For comparison, patients were divided according by results of the urine culture into E. coli and non-E. coli UTI groups. Results : A total of 84 patients participated in this study. Twenty one cases (25.0%) were caused by non-E. coli pathogens. Frequency of non-E. coli UTI differed according to age and sex: 'male <6 months', 10.5%; 'male ${\geq}$6 months', 50.0%; 'female <6 months', 43.7%; and 'female ${\geq}$6 months', 25.0% (P=0.014). More patients who received previous antibiotic treatment (P=0.017), but fewer patients who showed hematuria (P=0.014) were included in the non-E. coli UTI group than in the E. coli UTI group. Comparison of antibiotic resistance showed that the non-E. coli UTI group possessed more strains that were resistant to cefazolin, cefotaxime, imipenem, trimethoprim/sulfamethoxazole (TMP/SMZ) and tetracycline than the E. coli UTI group (P<0.05). Conclusion : Increased incidence, different distribution by age and sex, and high antibiotic resistance of non-E. coli UTI should be considered in selection of empirical antibiotics for treatment of UTI in children.

목적:소아 UTI에서 non-E. coli UTI 의 빈도를 확인하고 원인균주별(E. coli vs. non-E. coli) 임상양상과 항생제 내성률을 비교하고자 하였다. 방 법: 2008년 9월부터 2009년 8월까지 UTI 입원 환아 중에서 원인균주가 배양 증명된 환아들을 대상으로 하였다. 인구학적 특징, 임상양상, 검사소견, 원인균주와 항생제 내성률을 전향적으로 조사하였다. 결과:전체 84명 중 E. coli UTI 은 63명(75.0%)이었고 non-E. coli UTI은 21명(25.0%)이었다. 성별 연령군에 따라서 non-E. coli의 분포는 차이를 보였다 : 6개월 미만 남아군, 10.5%; 6개월 이상 남아군, 50.0%; 6개월 미만 여아군, 43.7%; 6개월 이상 여아군, 25.0% (P =0.014). E. coli UTI군에 비해, non-E. coli UTI 군에는 입원 전 항생제를 치료받은 환아의 비율이 높았고(P=0.017), 혈뇨가 동반된 환아의 비율은 낮았다(P=0.014). E. coli 보다 non-E. coli는 cefazolin과 cefotaxime, imipenem, TMP/SMX, tetracycline에 대해 높은 내성률을 보였다(P<0.05). 결론:소아 UTI 치료과정에서, 증가 추세의 non-E. coli UTI 빈도와 성별 연령군별 원인균주의 차이, E. coli 보다 높은 non-E. coli의 항생제 내성률은 고려되어야 할 사항이다.

Keywords

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