Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
권호 표지
DOI QR코드

DOI QR Code

Antibiotic Sensitivity Patterns in Children with Urinary Tract Infection: Retrospective Study Over 8 Years in a Single Center

  • Received : 2018.02.23
  • Accepted : 2018.06.19
  • Published : 2019.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: We studied the pathogens and trends in antibiotic sensitivity pattern in children with urinary tract infection (UTI) over 8 years in order to evaluate adequate treatment. Methods: We performed a retrospective review of medical records of children with UTI from January 2009 to December 2016 in Daegu Fatima Hospital. Uropathogens and antibiotic sensitivity patterns were selected. Only 1 bacterial species with a colony count of ${\geq}105CFU/mL$ was considered a positive result. We compared 2 periods group (A: 2009~2012, B: 2013~2016) to investigate trends of antibiotic sensitivity pattern. Results: During the 8 year period, 589 cases are identified (E. coli was cultured in 509 cases, 86.4%). Among all patients, this study investigated the antibiotic sensitivity of E. coli. Antimicrobial susceptibility to ampicillin was steadily low for both periods (A: 32.6%, B: 40.1%, P=0.125), and to amikacin was consistently high for both periods (A: 99.4%, B: 99.3%, P=1.000). Antibiotic sensitivity to third-generation cephalosporin decreased from period A to B (A: 91.7%, B: 75.5%, P=0.000). Antibiotic sensitivity to quinolone significantly decreased from A to B (A: 88.4%, B: 78.2%, P=0.003). The prevalence of extended-spectrum ${\beta}$-lactamase-producing E. coli increased from period A to B (A: 6.1%, B: 17.1%, P=0.000). Conclusion: This study showed that conventional antibiotic therapy for the treatment of pediatric UTI needs to be reevaluated. A careful choice of antibiotic is required due to the change in antibiotic sensitivity and the emergence of antibiotic-resistant bacteria.

Keywords

References

  1. Brouhard BH, Travis LB. Infections of the urinary tract. In : Rudolph AM, editors. Pediatrics. 18th ed. Appleton & Lange Co, 1987:1197-202.
  2. Hoberman A, Chao HP, Keller DM, Hickey R, Davis HW, Ellis D. Prevalence of urinary tract infection in febrile infants. J Pediatr 1993;123:17-23. https://doi.org/10.1016/S0022-3476(05)81531-8
  3. Elder JS. Urinary tract infections. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, Behrman RE, eds. Nelson textbook of pediatrics. 19th ed. Philadelphia, PA : Elsevier;2011:1829-834.
  4. Fernbach SK, Maizels M, Conway JJ. Ultrasound garding of hydronephrosis: Introduction to the system used by the society for fetal urology. Pediatr Radiol 1993;23:478-80. https://doi.org/10.1007/BF02012459
  5. Kang CI, Kim SH, Park WB, Lee KD, Kim HB, Kim EC,et al. Bloodstream infections caused by antibiotic-resistant gram-negative bacilli: risk factors for mortality and impact of inappropriate initial antimicrobial therapy on outcome. Antimicrob Agents Chemother 2005;49:760-6. https://doi.org/10.1128/AAC.49.2.760-766.2005
  6. Karami N, Martner A, Enne VI, Swerkersson S, Adlerberth I, Wold AE. Transfer of an ampicillin resistance gene between two Escherichia coli strains in the bowel microbiota of an infant treated with antibiotics. J Antimicrob Chemother 2007;60:1142-5. https://doi.org/10.1093/jac/dkm327
  7. Lee YK, Lee HJ, Kim JM, Kang JM, Lee ST, Lee NY, Kim YJ, Cho HY. The Antibiotic Resistance Pattern of Gram-Negative Bacteria in Children Younger Than 24 Months with a Urinary Tract Infection: A Retrospective Single-Center Study over 15 Consecutive Years. Child Kidney Dis 2015;19:148-53. https://doi.org/10.3339/chikd.2015.19.2.148
  8. Song YH, Kim DH, Park JY, Choi CH, Cho EY, Kim SM,et al. Escherichia coli susceptibility to antimicrobials in children with urinary tract infection. J Korean Soc Pediatr Nephrol 2006;10:192-200.
  9. Ko JH, Lee JH, Shim EJ, Cho DJ, Min KS, Yoo KY, Lee DH, Kang HJ. Microbiological spectrum and antibiotic susceptibility pattern in more than 24-month-old children with urinary tract infection: A6-year retrospective, single center experience. Korean J Pediatr 2009;52:1147-52. https://doi.org/10.3345/kjp.2009.52.10.1147
  10. Zhanel GG, Hisanaga TL, Laing NM, DeCorby MR, Nichol KA, Weshnoweski B, Johnson J, Noreddin A, Low DE, Karlowsky JA; NAUTICA Group, Hoban DJ. Antibiotic resistance in Escherichia coli outpatient urinary isolates: final results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA). Int J Antimicrob Agents 2006;27:475-88.
  11. Jang MK, Chu JM, Lee HS, Kim JS. Changes of antimicrobial resistance of Gram negative bacilli isolated in Chonbuk national university hospital(1993-1997). J Korean Pediatr Soc 2000;43:625-31.
  12. Yoon JE, Kim WK, Lee JS, Shin K-S, Ha T-S. Antibiotic susceptibility and imaging findings of the causative microorganisms responsible for acute urinary tract infection in children: a five-year single center study. Korean J Pediatr 2011;54:79-85. https://doi.org/10.3345/kjp.2011.54.2.79
  13. Yun KW. Principles of antibiotic therapy in pediatric emergency department. Pediatr Emerg Med J 2015;2:59-66. https://doi.org/10.22470/pemj.2015.2.2.59
  14. Kim SH, YooRN, Lee JA. The impact of the antibiotic burden on the selection of its resistance among gram negative bacteria isolated from children. Pediatr Infect Vaccine 2015;22:178-85. https://doi.org/10.14776/piv.2015.22.3.178
  15. Hur JK. The use of fluoroquinolone in children. Korean J Pediatr 2008;51:1042-6. https://doi.org/10.3345/kjp.2008.51.10.1042
  16. Aihua Wang, Yonghong Yang, Quan Lu, Yi Wang, Yuan Chen, Li Deng,et al. Presence of qnr gene in Escherichia coli and Klebsiella pneumoniae resistant to ciprofloxacin isolated from pediatric patients in China. BMC Infectious Diseases 2008;8:68. https://doi.org/10.1186/1471-2334-8-68
  17. Du Bois SK, Marriot MS, Amyes S.G. TEM- and SHV-derived extended-spectrum beta-lactamase : Relationship between selection, structure and function. J Antimicrob Chemother 1995;35:7-22. https://doi.org/10.1093/jac/35.1.7
  18. Pai H. The characteristics of extended-spectrum beta-lactamases in Korean isolates of Enterobacteriaceae. Yonsei Med J 1998;39:514-9. https://doi.org/10.3349/ymj.1998.39.6.514
  19. Lee JW, Shin JS, Seo JW, Lee MA, Lee SJ. Incidence and Risk Factors for Extended-Spectrum beta-Lactamase-Producing Escherichia coli in Community-acquired Childhood Urinary Tract Infection. J Korean Soc Pediatr Nephrol 2004;8:214-222.
  20. Park C, Kim MS, Kim MK, Yim HE, Yoo KH, Hong YS, Lee JW. Clinical Significance of Extended-Spectrum beta-Lactamase Producing Escherichia coli in Pediatric Patients with Febrile Urinary Tract Infection. J Korean Soc Pediatr Nephrol 2012;16:38-45. https://doi.org/10.3339/jkspn.2012.16.1.38
  21. Ahn DH, Kim KW, Cho HK, Tchah H, Jeon IS, Ryoo E, Sun YH. Febrile Urinary Tract Infections Caused by Community-Acquired Extended-Spectrum beta-Lactamase-Producing and-Nonproducing Bacteria: A Comparative Study. Pediatr Infect Vaccine 2015;22:29-35. https://doi.org/10.14776/piv.2015.22.1.29
  22. Kim NH, Lee JA, Kim YK, Choi EH, Ha IS, Lee HJ, Choi Y. Risk Factors of Urinary Tract Infections Due to Extended-spectrum ${\beta}$-lactamase Producing Escherichia coli in Children. Korean J Pediatr 2004;47:164-9.

Cited by

  1. Non-carbapenem antimicrobial therapy in young infant with urinary tract infections caused by community-acquired extended-spectrum β-lactamase-producing Escherichia coli vol.62, pp.3, 2019, https://doi.org/10.1016/j.pedneo.2021.01.005