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KMID : 1234520090040020210
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Korean Journal of Urogenital Tract Infection Inflammation
2009 Volume.4 No. 2 p.210 ~ p.219
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Antibiotic Resistance Patterns of Escherichia coli and Non-Escherichia coli Gram Negative Uropathogens in Pediatric Urinary Tract Infections for the Years 2001-2008
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Kim Jun-Mo
Kim Young-Ho
Kim Min-Eui
Lee Kwang-Woo
Sin Hue-Bong
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Abstract
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Purpose: Because many gram negative bacterial species among the members of the Enterobacteriaceae are implicated hospital acquired infection including catheter-associated infection, antimicrobial resistance between Escherichia coli (E. coli) and other gram negative uropathogens could be different. We evaluated the epidemiologic data and antibiotic resistance patterns of E. coli and other gram negative uropathogens.
Materials and Methods : Between February 2001 and November 2008, we retrospectively analyzed positive urine samples of 618 pediatric patients under 15 years of age with the first urinary tract infection (UTI) by E. coli and 419 other gram negative uropathogens. Mean age was 1.0±2.4 years. We compared antibiotic resistnace rate according to E. coli and non-E. coli group, each gram negative bacteria, age group, gender, and early and late period.
Results: Although resistance rate of E. coli to ciprofloxacin (9.7%) and co-trimoxazole (34.1%) is higher than non-E. coli gram negative uropathogen (2.4%, 21.5%), resistance rate of non-E. coli gram negative uropathogen to ampicillin (90.9%), amoxicillin-clavulanic acid (52.0%), 1st to 3rd generation cephalosporins (65.2% to 23.6%), and imipenem (2.6%) is higher than E. coli. The resistance rate to co-trimoxazole of age group of 1-15 years is higher than age group of less than 1 year in both E. coli (44.0% Vs 30.4%) and non-E. coli gram negative uropathogens (28.0% Vs 18.9%). In comparison between early and late period, resistance rate to 3rd generation cephalosporin (32.9% Vs 17.6%) and gentamicin (36.0% Vs 16.1%) was decreased.
Conclusions: The resistance rate of gram negative uropathogens other than E. coli to ampicillin, cephalosporins, and imipenem was higher than E. coli. Because our result shows resistance rate to amikacin is low in all of gram negative uropathogen including E. coli, it could be reasonable choice in the empirical treatment of the first UTI in children.
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KEYWORD
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Urinary tract infection, Antibiotic resistance pattern, Escherichia coli, Gram-negative bacteria
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