title: Antimicrobial susceptibility of uropathogens isolated from Cambodian children.
abstract: Bacterial resistance to commonly used antimicrobials is an increasing problem in Asia but information concerning the antimicrobial susceptibility of bacteria causing urinary tract infections (UTIs) in children is limited.
  
  
  
  This was a 5-year retrospective study of children with suspected UTI attending a paediatric hospital in north-west Cambodia. Urines with a positive culture containing a single organism with a count of >10(5) colony-forming units (CFU)/ml were considered diagnostic of infection. The organism was identified and the resistance pattern (using CLSI guidelines) and presence of an extended-spectrum β-lactamase (ESBL) phenotype was determined.
  
  
  
  In total, there were 217 episodes of infection, 210 (97%) with Gram-negative bacteria. Escherichia coli was the most common infecting isolate with high levels of resistance to most oral antibiotics, except nitrofurantoin. Nearly half of the E. coli (44%) were extended-spectrum cephalosporin (ESC)-resistant with the proportion increasing significantly over the 5-year period. ESC-resistant E. coli were more likely to be multi-drug-resistant and 91% demonstrated an ESBL phenotype.
  
  
  
  The data highlight the importance of microbiological surveillance of UTIs in children, particularly in areas where there are known to be multiply resistant organisms.
authors.affiliation: a Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University , Bangkok , Thailand.|b Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Churchill Hospital , Oxford , UK.
authors.forename: Catrin E
authors.initials: CE
authors.lastname: Moore
authors.affiliation: c Angkor Hospital for Children , Siem Reap , Cambodia.
authors.forename: Soeng
authors.initials: S
authors.lastname: Sona
authors.affiliation: c Angkor Hospital for Children , Siem Reap , Cambodia.
authors.forename: Sar
authors.initials: S
authors.lastname: Poda
authors.affiliation: c Angkor Hospital for Children , Siem Reap , Cambodia.
authors.forename: Hor
authors.initials: H
authors.lastname: Putchhat
authors.affiliation: c Angkor Hospital for Children , Siem Reap , Cambodia.
authors.forename: Varun
authors.initials: V
authors.lastname: Kumar
authors.affiliation: c Angkor Hospital for Children , Siem Reap , Cambodia.
authors.forename: Sun
authors.initials: S
authors.lastname: Sopheary
authors.affiliation: a Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University , Bangkok , Thailand.|b Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Churchill Hospital , Oxford , UK.
authors.forename: Nicole
authors.initials: N
authors.lastname: Stoesser
authors.affiliation: a Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University , Bangkok , Thailand.|b Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Churchill Hospital , Oxford , UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Bousfield
authors.affiliation: a Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University , Bangkok , Thailand.|b Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Churchill Hospital , Oxford , UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Day
authors.affiliation: a Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University , Bangkok , Thailand.|b Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Churchill Hospital , Oxford , UK.|d Clinical Sciences, Liverpool School of Tropical Medicine , UK.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Parry
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002160:Cambodia; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cambodia; Children; Escherichia coli; ESBL; Resistance; Urinary tract infection