title: Antimicrobial resistance among Escherichia coli that cause childhood community-acquired urinary tract infections in Northern Italy.
abstract: BACKGROUND
  Resistance rate of Escherichia coli against antimicrobials that are commonly prescribed in pediatric urinary tract infections is currently a matter of concern.
  
  
  METHODS
  The antimicrobial susceptibility patterns of uropathogenic Escherichia coli strains to the common antibimcrobials ampicillin, cotrimoxazole, coamoxyclav, ceftazidime, ceftriaxone, nitrofurantoin, and gentamycin were determined in 177 children aged from 2 to 36 months. They presented with their first symptomatic community acquired urinary tract infection at the Department of Pediatrics, San Leopoldo Mandic Hospital, Merate-Lecco.
  
  
  RESULTS
  High rates of ampicillin (inpatients: 50%; outpatients: 52%) resistance were identified. The resistance for cotrimoxazole (inpatients: 22%; outpatients: 15%) and especially coamoxyclav (inpatients: 6%; outpatients: 10%) was less pronounced than that to ampicillin. No resistance or less than 1% of resistance was identified for ceftazidime, ceftriaxone, nitrofurantoin, and gentamycin both in inpatients and in outpatients.
  
  
  CONCLUSIONS
  Italian children affected with a community acquired urinary tract infection are initially managed orally with coamoxyclav or parenterally with ceftriaxone. The results of the present retrospective analysis support this attitude. Parenteral ceftriaxone or an aminoglycoside should be considered for patients on antimicrobial prophylaxis or recently prescribed antimicrobials.
authors.affiliation: Department of Clinical Laboratory, San Leopoldo Mandic Hospital, Merate-Lecco, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Caracciolo
authors.forename: Alberto
authors.initials: A
authors.lastname: Bettinelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Bonato
authors.forename: Clementina
authors.initials: C
authors.lastname: Isimbaldi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tagliabue
authors.forename: Laura
authors.initials: L
authors.lastname: Longoni
authors.forename: Mario G
authors.initials: MG
authors.lastname: Bianchetti
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents