title: [Practical problems related to the management of febrile urinary tract infection in Vietnamese children].
abstract: BACKGROUND
  To describe the practical problems related to urinary tract infection (UTI) management in febrile Vietnamese children.
  
  
  METHODS
  During a prospective 28-month inclusion period, 143 febrile children with significant bacteriuria were treated for UTI in the nephrology department of Nhi Dong 2 children's hospital in Ho Chi Minh City, Vietnam. Patients were treated after blood and urine samples had been taken for culture, according to a local antibiotic protocol, parenterally with ceftriaxone 75mg/kg/day. Oral treatment with cefixime 8mg/kg/day was started after 48h of apyrexia for 2 weeks. According to local protocol, antibiotic therapy was only changed if children did not respond clinically to treatment regardless of antibiogram results.
  
  
  RESULTS
  Among these 143 children, 51% were girls and 80% of them had their first UTI before the age of 2 years. The commonest causative agent was Escherichia coli (80% of cases) with a high resistance rate to ampicillin (91%) and cotrimoxazole (74%). Extended-spectrum β-lactamase (ESBL) production was observed in 52% of Enterobacteriaceae isolates. According to antibiotic susceptibility, the initial treatment with ceftriaxone was found to be inappropriate in 63% of cases.
  
  
  CONCLUSIONS
  E. coli was responsible for 80% of UTIs in Vietnamese children with a high rate of resistance to first-line antibiotics. ESBL production was found to be extremely high in this study. Based on these data, we propose a new empiric treatment schedule for Vietnamese children suspected of UTI.
authors.affiliation: Département de néphrologie pédiatrique, hôpital Nhi Dong 2, université Pham Ngoc Thach, 14, Ly Tu Trong, Quận 1, Hô-Chi-Minh, Viet Nam. Electronic address: Duong.Hong.Phuoc@ulb.ac.be.
authors.forename: H P
authors.initials: HP
authors.lastname: Duong
authors.affiliation: Département de néphrologie pédiatrique, hôpital Nhi Dong 2, université Pham Ngoc Thach, 14, Ly Tu Trong, Quận 1, Hô-Chi-Minh, Viet Nam.
authors.forename: T T
authors.initials: TT
authors.lastname: Mong Hiep
authors.affiliation: Département de néphrologie pédiatrique, hôpital Nhi Dong 2, université Pham Ngoc Thach, 14, Ly Tu Trong, Quận 1, Hô-Chi-Minh, Viet Nam.
authors.forename: D T
authors.initials: DT
authors.lastname: Hoang
authors.affiliation: Département de néphrologie pédiatrique, hôpital universitaire des Enfants-Reine-Fabiola, université Libre de Bruxelles (ULB), Bruxelles, Belgique.
authors.forename: F
authors.initials: F
authors.lastname: Janssen
authors.affiliation: Département des maladies infectieuses, hôpital universitaire des Enfants-Reine-Fabiola, université Libre de Bruxelles (ULB), Bruxelles, Belgique.
authors.forename: P
authors.initials: P
authors.lastname: Lepage
authors.affiliation: Département de microbiologie médicale, CHU Sart-Tilman, université de Liège (ULg), Liège, Belgique.
authors.forename: P
authors.initials: P
authors.lastname: De Mol
authors.affiliation: Département des maladies infectieuses, hôpital universitaire des Enfants-Reine-Fabiola, université Libre de Bruxelles (ULB), Bruxelles, Belgique.
authors.forename: S
authors.initials: S
authors.lastname: Blumental
authors.affiliation: Département de néphrologie pédiatrique, hôpital universitaire des Enfants-Reine-Fabiola, université Libre de Bruxelles (ULB), Bruxelles, Belgique.
authors.forename: K
authors.initials: K
authors.lastname: Ismaili
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004927:Escherichia coli Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone