Cephalosporin resistant urinary tract infections in young children.
OBJECTIVE
To describe the antibiotic resistance pattern of bacteria causing urinary tract infection (UTI) in a cohort of Australian children under 6 years of age.


METHODS
Data were collected over a 12-month period from children under 6 years of age with a provisional diagnosis of UTI made in the Emergency Department of Sunshine Hospital, Victoria.


RESULTS
During the study period 100 culture-proven UTI were identified in 97 children. Three children had two episodes. Out of the 100 episodes, 39% were male, 56% were under 12 months of age at presentation and 61% were managed as outpatients. Clinical features were non-specific in the majority of cases. Hydronephrosis and vesicoureteric reflux was detected in 5.5% and 28.6%, respectively, of children with their first investigated UTI. A single bacterial isolate was cultured from 97 urines and two from three samples. Escherichia coli (n = 90) and Proteus mirabilis (n = 5) were the most common isolates. In vitro resistance to ampicillin/amoxycillin was found in 52% of isolates, to trimethoprim in 14% and to cephalothin/cephalexin in 24%. This resistance rate to first generation cephalosporins is the highest reported to date in adult or paediatric UTI in Australia.


CONCLUSIONS
Ampicillin/amoxycillin or cephalothin/cephalexin may not be the optimal choice of antibiotic for the empiric treatment of UTI in this and possibly other paediatric populations.
Mehr
S S
SS
Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Australia.
Powell
C V E
CV
Curtis
N
N
D018550:Cephalosporin Resistance / Q000502:physiology*; D002648:Child; D015331:Cohort Studies; D004927:Escherichia coli Infections / Q000382:microbiology; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D015995:Prevalence; D011512:Proteus Infections / Q000382:microbiology; D014463:Ultrasonography; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*