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Changes in bacterial resistance patterns in children with urinary tract infections on antimicrobial prophylaxis at University Hospital in Split.

Ilić T, Gračan S, Arapović A, Capkun V, Subat-Dežulović M, Saraga M - Med. Sci. Monit. (2011)

Bottom Line: Both groups displayed significantly less resistance of Enterococcus sp.In patients receiving LTAP before hospitalization, E. coli was significantly more resistant to ampicillin, amoxicillin/clavulonic acid and TMP/SMX than in those without LTAP.Based on our results, we recommend excluding ampicillin altogether, and reconsideration of further use of TMP-SMX, as well as use of nitrofurantoin, cephalexin and amoxicillin/clavulonic acid for LTAP in our region.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, University of Split, Split, Croatia.

ABSTRACT

Background: We assessed prevalence and resistance of uropathogens on antimicrobial agents (AA) from urine cultures (UC) in children hospitalized with urinary tract infections (UTI) at University Hospital in Split.

Material/methods: During the 7-year period, children hospitalized only once with UTI alone were compared to those repeatedly hospitalized, and who received long-term antimicrobial prophylaxis (LTAP), as well as those with associated anomalies of the urinary system (US).

Results: E. coli was the most frequent isolate (67.7%) with resistance to ampicillin by 69.5%, amoxicillin/clavulonic acid by 3.5%, cephalexin by 6.6%, trimethoprim/sulfamethoxazole (TMP-SMX) by 27.5%, and nitrofurantoin by 0.4%. For other uropathogens, AA resistance rates were the following: 64.3%, 5.8%, 10.5%, 21.3%, and 7.9%. The high or increasing resistance to TMP-SMX is characterized by all uropathogens. Patients with anomalies of US showed a lower prevalence of E. coli and Enterococcus sp., but a higher prevalence of Pseudomonas sp., ESBL-producing E. coli and Klebsiella sp. than those without US anomalies. Repeatedly hospitalized patients showed a lower prevalence of E. coli, but a higher prevalence of Pseudomonas sp. and Klebsiella sp. than patients hospitalized only once. Both groups displayed significantly less resistance of Enterococcus sp. In patients receiving LTAP before hospitalization, E. coli was significantly more resistant to ampicillin, amoxicillin/clavulonic acid and TMP/SMX than in those without LTAP.

Conclusions: Based on our results, we recommend excluding ampicillin altogether, and reconsideration of further use of TMP-SMX, as well as use of nitrofurantoin, cephalexin and amoxicillin/clavulonic acid for LTAP in our region.

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Related in: MedlinePlus

This figure shows significantly higher prevalence of Pseudomonas sp. and Klebsiella sp. in patients who were hospitalized for UTI more than once.
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getmorefigures.php?uid=PMC3539571&req=5

f3-medscimonit-17-7-cr355: This figure shows significantly higher prevalence of Pseudomonas sp. and Klebsiella sp. in patients who were hospitalized for UTI more than once.

Mentions: In this study the prevalence of uropathogens in terms of the number of hospitalizations showed that patients hospitalized more than once had a lower chance of having isolated E. coli. However, they had approximately a 3 times greater frequency of UTI caused by Pseudomonas sp. and a 2 times greater frequency of UTI caused by Klebsiella sp. than patients who were hospitalized only once (Figure 3).


Changes in bacterial resistance patterns in children with urinary tract infections on antimicrobial prophylaxis at University Hospital in Split.

Ilić T, Gračan S, Arapović A, Capkun V, Subat-Dežulović M, Saraga M - Med. Sci. Monit. (2011)

This figure shows significantly higher prevalence of Pseudomonas sp. and Klebsiella sp. in patients who were hospitalized for UTI more than once.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539571&req=5

f3-medscimonit-17-7-cr355: This figure shows significantly higher prevalence of Pseudomonas sp. and Klebsiella sp. in patients who were hospitalized for UTI more than once.
Mentions: In this study the prevalence of uropathogens in terms of the number of hospitalizations showed that patients hospitalized more than once had a lower chance of having isolated E. coli. However, they had approximately a 3 times greater frequency of UTI caused by Pseudomonas sp. and a 2 times greater frequency of UTI caused by Klebsiella sp. than patients who were hospitalized only once (Figure 3).

Bottom Line: Both groups displayed significantly less resistance of Enterococcus sp.In patients receiving LTAP before hospitalization, E. coli was significantly more resistant to ampicillin, amoxicillin/clavulonic acid and TMP/SMX than in those without LTAP.Based on our results, we recommend excluding ampicillin altogether, and reconsideration of further use of TMP-SMX, as well as use of nitrofurantoin, cephalexin and amoxicillin/clavulonic acid for LTAP in our region.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, University of Split, Split, Croatia.

ABSTRACT

Background: We assessed prevalence and resistance of uropathogens on antimicrobial agents (AA) from urine cultures (UC) in children hospitalized with urinary tract infections (UTI) at University Hospital in Split.

Material/methods: During the 7-year period, children hospitalized only once with UTI alone were compared to those repeatedly hospitalized, and who received long-term antimicrobial prophylaxis (LTAP), as well as those with associated anomalies of the urinary system (US).

Results: E. coli was the most frequent isolate (67.7%) with resistance to ampicillin by 69.5%, amoxicillin/clavulonic acid by 3.5%, cephalexin by 6.6%, trimethoprim/sulfamethoxazole (TMP-SMX) by 27.5%, and nitrofurantoin by 0.4%. For other uropathogens, AA resistance rates were the following: 64.3%, 5.8%, 10.5%, 21.3%, and 7.9%. The high or increasing resistance to TMP-SMX is characterized by all uropathogens. Patients with anomalies of US showed a lower prevalence of E. coli and Enterococcus sp., but a higher prevalence of Pseudomonas sp., ESBL-producing E. coli and Klebsiella sp. than those without US anomalies. Repeatedly hospitalized patients showed a lower prevalence of E. coli, but a higher prevalence of Pseudomonas sp. and Klebsiella sp. than patients hospitalized only once. Both groups displayed significantly less resistance of Enterococcus sp. In patients receiving LTAP before hospitalization, E. coli was significantly more resistant to ampicillin, amoxicillin/clavulonic acid and TMP/SMX than in those without LTAP.

Conclusions: Based on our results, we recommend excluding ampicillin altogether, and reconsideration of further use of TMP-SMX, as well as use of nitrofurantoin, cephalexin and amoxicillin/clavulonic acid for LTAP in our region.

Show MeSH
Related in: MedlinePlus