ESPN 51th Annual Meeting

ESPN 2018

Escherichia coli in small children with urinary tract infection;influence of age and gender on antimicrobial resistance
├ůSA BERGQVIST 1 Svante Swerkersson 1


Urinary tract infection (UTI) is a common infection in small children, mostly caused by Escherichia coli (E.coli). The resistance pattern of E.coli has impact on the treatment and probably also the outcome of UTI in children. It is therefore of interest to investigate possible factors influencing the presence of antimicrobial resistance.
The aim of this retrospective study was to analyse the correlation between age and gender upon antimicrobial resistance of E.coli in a Swedish population of small children.

Material and methods:

Included were 116 girls and 99 boys younger than 24 months with a first time, community acquired, symptomatic, UTI, diagnosed between 2006 and 2016. Non-E.coli infections were excluded as were children with obstructive uropathy.


The median age at diagnosis was 8.0 months for girls and 3.5 months for boys. The overall E.coli resistance to trimethoprim (TMP) was 21.0% (45/214), cefadroxil 3.8% (8/212) and nitrofurantoin 0%. The resistance for boys and girls was 22.5% and 19.8% to TMP (p=0.74), 3.1% and 4.4% to cefadroxil (p=0.73), respectively. Resistance to TMP was not related to age (p=0.64) in contrast to cefadroxil where a significant relation was found (p=0.042). Accordingly, comparing children <10 months and ≥10 months of age resistance to TMP was 19.9% and 23.9% (p=0.6), to cefadroxil 1.4% and 9.9% (p=0.012), respectively.  


In Sweden E.coli antimicrobial resistance to TMP is high and whereas resistance to cefadroxil and nitrofurantoin still is at a low level. In this study resistance to TMP was not related to gender or age. In contrast resistance to cefadroxil was significantly more prevalent in children above 10 months of age which indicates that children in this age-group may have an increased risk of colonization by resistant microbes.