title: Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children.
abstract: OBJECTIVE
  To determine which children with urinary tract infection are likely to have pathogens resistant to narrow-spectrum antimicrobials.
  
  
  METHODS
  Children, 2-71 months of age (n = 769) enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux or Careful Urinary Tract Infection Evaluation studies were included. We used logistic regression models to test the associations between demographic and clinical characteristics and resistance to narrow-spectrum antimicrobials.
  
  
  RESULTS
  Of the included patients, 91% were female and 76% had vesicoureteral reflux. The risk of resistance to narrow-spectrum antibiotics in uncircumcised males was approximately 3 times that of females (OR 3.1; 95% CI 1.4-6.7); in children with bladder bowel dysfunction, the risk was 2 times that of children with normal function (OR 2.2; 95% CI 1.2-4.1). Children who had received 1 course of antibiotics during the past 6 months also had higher odds of harboring resistant organisms (OR 1.6; 95% CI 1.1-2.3). Hispanic children had higher odds of harboring pathogens resistant to some narrow-spectrum antimicrobials.
  
  
  CONCLUSIONS
  Uncircumcised males, Hispanic children, children with bladder bowel dysfunction, and children who received 1 course of antibiotics in the past 6 months were more likely to have a urinary tract infection caused by pathogens resistant to 1 or more narrow-spectrum antimicrobials.
authors.affiliation: Division of General Academic Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
authors.forename: Nader
authors.initials: N
authors.lastname: Shaikh
authors.affiliation: Division of General Academic Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hoberman
authors.affiliation: Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Ron
authors.initials: R
authors.lastname: Keren
authors.affiliation: Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Ivanova
authors.affiliation: Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Nathan
authors.initials: N
authors.lastname: Gotman
authors.affiliation: Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Russell W
authors.initials: RW
authors.lastname: Chesney
authors.affiliation: Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Myra A
authors.initials: MA
authors.lastname: Carpenter
authors.affiliation: National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
authors.forename: Marva
authors.initials: M
authors.lastname: Moxey-Mims
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Wald
mesh_terms: D000658:Amoxicillin / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000494:pharmacology*; D002511:Cephalosporins / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli; D005260:Female; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D009582:Nitrofurantoin / Q000494:pharmacology; D016017:Odds Ratio; D012044:Regression Analysis; D013420:Sulfamethoxazole / Q000494:pharmacology; D014295:Trimethoprim / Q000494:pharmacology; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D014718:Vesico-Ureteral Reflux / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000890:Anti-Infective Agents; D002511:Cephalosporins; D000658:Amoxicillin; D009582:Nitrofurantoin; D014295:Trimethoprim; D013420:Sulfamethoxazole