ESPN 51th Annual Meeting

ESPN 2018


 
ETIOLOGICAL AGENTS AND ANTIMICROBIAL SUSCEPTIBILITY IN CHILDREN WITH URINARY TRACT INFECTION
SOFIA HELENA FERREIRA 1 SARA MADUREIRA GOMES 1 JOANA P. NUNES 1 JOANA JARDIM 1 JOÃO LUÍS BARREIRA 1 HELENA PINTO 1

1- CENTRO HOSPITALAR DE SÃO JOÃO
 
Introduction:

Urinary tract infection (UTI) remains one of the most common bacterial infection in pediatric population. It may be associated with long-term sequels, including hypertension, proteinuria and progressive renal failure. At present, antibiotic resistance appears as a major public health problem. Accordingly, it is important to evaluate systematically the prevalence of uropathogens and their antimicrobial susceptibility profile. The objective of this study was to evaluate etiological agents responsible for UTI and antimicrobial susceptibility profile.

Material and methods:

We performed a retrospective study, in which we analyzed the patients admitted in a level III Pediatric Hospital with the diagnosis of UTI between 2013 and 2016. There were evaluated demographic and clinical characteristics (sex, age, history of urinary tract malformation, prior UTI, presentation symptoms, urine collection method, treatment), uropathogen identified and antimicrobial susceptibility profile.

Results:

We analyzed a total of 3932 pediatric patients data, with a female predominance. The uropathogen most frequently identified was Escherichia coli and its prevalence was similar through the years analyzed (2013: 55,8%, 2014: 61,0%, 2015: 58,7%, 2016: 59,3%). Regarding the susceptibility profile, we described increased resistance to amoxicillin-clavulanate from 5,3% (in 2013) to 20,8% (in 2016) and to cefuroxime from 2,3% (in 2013) to 5,8% (in 2016). Considering antibiotics usually prescribed for prevention of UTI, we found a slight decreasing trend for nitrofurantoin (from 17,9% to 13,5%), but not for trimethoprim-sulfamethoxazole (from 18,7% to 17,4%). The prevalence of extended spectrum beta-lactamase (ESBL) producing organisms remained similar (2013: 2,3%, 2014: 3,1%, 2015: 2,9%, 2016: 3,4%).

Conclusions:

As Escherichia coli remains the main etiological agent of UTI, its antimicrobial sensitivity profile should guide empirical and local therapeutic choice. The increased resistance to amoxicillin-clavulanate described is an alert for its inappropriate and/or excessive use, considering that this antibiotic plays an important role in the empirical treatment of UTIs and even in infections with ESBL producing uropathogens.