title: First-Line Antimicrobial Resistance Patterns of Escherichia coli in Children With Urinary Tract Infection in Emergency Department and Primary Care Clinics.
abstract: OBJECTIVE
  To identify risk factors for antibiotic resistance to Escherichia coli (E. coli) in children with urinary tract infections (UTIs) in emergency room and primary care clinics.
  
  
  METHODS
  This is a cross-sectional study of children 0 to 18 years of age reported to have E coli-positive UTIs whose medical and laboratory records were systematically reviewed.
  
  
  RESULTS
  Compared with girls, boys were 2.29 times (confidence interval [CI] = 1.30-4.02) more likely to have E coli isolates resistant to ampicillin and 2 times more likely (CI = 1.13-3.62) to have isolates resistant to trimethoprim-sulfamethoxazole (TMP/SMX). Patients with genitourinary abnormalities were 1.57 times more likely to be resistant to ampicillin (CI = 1.03-2.41) and 1.86 times to TMP/SMX (CI = 1.18-2.94).
  
  
  CONCLUSIONS
  Higher rates of ampicillin and TMP/SMX resistant urinary E coli isolates were observed among boys and children with a history of genitourinary abnormality. Age and recent antibiotic prescription are also potential risk factors for resistance.
authors.affiliation: Carle Foundation Hospital, Urbana, IL, USA University of Illinois College of Medicine, Urbana, IL, USA nadeem.ahmed@carle.com.
authors.forename: M Nadeem
authors.initials: MN
authors.lastname: Ahmed
authors.affiliation: Carle Foundation Hospital, Urbana, IL, USA.
authors.forename: Debby
authors.initials: D
authors.lastname: Vannoy
authors.affiliation: Carle Foundation Hospital, Urbana, IL, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Frederick
authors.affiliation: University of Illinois College of Medicine, Urbana, IL, USA.
authors.forename: Sandy
authors.initials: S
authors.lastname: Chang
authors.affiliation: Southern Illinois University Medical Center, Springfield, IL, USA.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lawler
mesh_terms: D000293:Adolescent; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D004636:Emergency Service, Hospital; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D006801:Humans; D007087:Illinois; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D011320:Primary Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
keywords: Escherichia coli; ampicillin; antibiotic resistance; antibiotics; cefazolin; children; pediatrics; risk factors; trimethoprim-sulfamethoxazole; urinary tract infection