[Clinical analysis of 22 cases community-acquired Pseudomonas aeruginosa urinary tract infection].
OBJECTIVE
To study the characteristics of community-acquired urinary tract infections (CAUTIs) in children, analyze the risk factors and the susceptibility of antibiotics, thus to provide references to the diagnosis and medication of Pseudomonas aeruginosa (PA)-CAUTIs. Mothod Totally 22 cases of PA-CAUTIs were selected in one hospital from Jan, 2006 to Jan, 2012, their clinical information, laboratory results and radiological images were collected, and were compared with the CAUTIs cased by E. coli of those randomly selected over the same period.


RESULTS
In those 22 cases with PA-CAUTIs, the mean value of protein level was (32.25 ± 13.81) mg/ml, 19 of them were hospitalized, 6 had urinary operation history, 7 of them had long-term usage of glucocorticoids or immunosuppressive agents, and 20 had underlying diseases. A total of 22 children with 26 PA-CAUTIs episodes were compared to E. coli-CAUTIs. Compared with E. coli-CAUTIs patients, children with PA-CAUTIs more often presented with a lower albumin (P = 0.017), a history of urinary operation(P = 0.03), more cases had a history of urinary operation (P = 0.03), a long-term usage of glucocorticoids or immunosuppressive medication (P = 0.044). Through multivariate logistic regression of variables that were significant in univariate analysis (with hospitalizations, long-term usage of glucocorticoids or immunosuppressive, albumin, underlying disease and urinary operation histories), and it turned out that underlying diseases (odds ratio 8.500, 95% CI 1.513 - 47.761, P = 0.037) and with urinary operation histories (odds ratio 6.196, 95% CI 1.120 - 34.273, P = 0.037) were proved as the independent risk factors for PA-CAUTIs. Those PA bacterial strains had a 36.36% resistance rate to piperacillin, aztreonam and gentamicin, a 31.82% resistance rate to cefepime and ceftazidime, while the resistance rate (4.55%) to carbapenem antibiotics was relatively low, only to bacillosporin all the strains were sensitive.


CONCLUSIONS
Underlying diseases and the urinary operation histories are the independent risk factors of the occurrence of PA-CAUTIs, carbapenem antibiotics and bacillosporin can be considered as the drugs of choice for its treatment.
Clinical Laboratory Center of Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Xiao-Hong
XH
Fu
Wen
W
Zhou
Xue-Mei
XM
Zhang
Yi-Bing
YB
Yin
Chun-Mei
CM
Jing
Lan
L
Liu
Jie
J
Zhao
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D011113:Polymyxins / Q000627:therapeutic use; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology
D000900:Anti-Bacterial Agents; D011113:Polymyxins