title: Resistance profile for pathogens causing urinary tract infection in a pediatric population, and antibiotic treatment response at a university hospital, 2010-2011.
abstract: BACKGROUND
  Urinary tract infection (UTI) is one of the most common bacterial infections in childhood and causes acute and chronic morbidity and long-term hypertension and chronic kidney disease.
  
  
  OBJECTIVE
  To describe the demographic characteristics, infectious agents, patterns of antibiotic resistance, etiologic agent and profile of susceptibility and response to empirical treatment of UTI in a pediatric population.
  
  
  METHODS
  This is a descriptive, retrospective study.
  
  
  RESULTS
  Included in the study were 144 patients, 1:2.06 male to female ratio. The most common symptom was fever (79.9%) and 31.3% had a history of previous UTI. 72.0% of the patients had positive urine leukocyte count (>5 per field), urine gram was positive in 85.0% of samples and gram negative bacilli accounted for 77.8% for the total pathogens isolated. The most frequent uropathogens isolated were Escherichia coli and Klebsiella pneumoniae. Our E.coli isolates had a susceptibility rate higher than 90% to most of the antibiotics used, but a resistance rate of 42.6% to TMP SMX and 45.5% to ampicillin sulbactam. 6.3% of E. coli was extended-spectrum beta-lactamases producer strains. The most frequent empirical antibiotic used was amikacin, which was used in 66.0% of the patients. 17 of 90 patients who underwent voiding cistouretrography (VCUG) had vesicoureteral reflux.
  
  
  CONCLUSIONS
  This study revealed that E. coli was the most frequent pathogen of community acquired UTI. We found that E. coli and other uropathogens had a high resistance rate against TMP SMX and ampicillin sulbactam. In order to ensure a successful empirical treatment, protocols should be based on local epidemiology and susceptibility rates.
authors: Pediatric Nephrologist, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: Catalina
authors: C
authors: Vélez Echeverri
authors: Pediatric Nephrologist, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: Lina María
authors: LM
authors: Serna-Higuita
authors: Pediatric Nephrologist, Universidad de Antioquia. Medellín Colombia.
authors: Ana Katherina
authors: AK
authors: Serrano
authors: Pediatric Nephrologist, Universidad de Antioquia. Medellín Colombia.
authors: Carolina
authors: C
authors: Ochoa-García
authors: Pediatric Nephrologist, Universidad de Antioquia. Medellín Colombia.
authors: Luisa
authors: L
authors: Rojas Rosas
authors: Medical Laboratory Technician, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: Ana
authors: A
authors: María Bedoya
authors: Pediatrician, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: Margarita
authors: M
authors: Suárez
authors: Pediatrician, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: Catalina
authors: C
authors: Hincapié
authors: Pediatrician, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: Adriana
authors: A
authors: Henao
authors: Pediatrician, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: Diana
authors: D
authors: Ortiz
authors: Pediatric Nephrologist, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: Juan José
authors: JJ
authors: Vanegas
authors: Clinical Epidemiologist, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: John Jairo
authors: JJ
authors: Zuleta
authors: Pediatrician, Hospital Pablo Tobón Uribe. Medellín Colombia.
authors: David
authors: D
authors: Espinal
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Escherichia coli; Urinary tract infection; bacterial; drug resistance