Author(s): Edlin RS, Shapiro DJ, Hersh AL, Copper HL
Purpose: We characterize the current national patterns of antibiotic resistance of outpatient pediatric urinary tract infection.
Materials and methods: We examined outpatient urinary isolates from patients younger than 18 years in 2009 using The Surveillance Network®, a database with antibiotic susceptibility results and patient demographic data from 195 United States hospitals. We determined the prevalence and antibiotic resistance patterns for the 6 most common uropathogens, ie Escherichia coli, Proteus mirabilis, Klebsiella, Enterobacter, Pseudomonas aeruginosa and Enterococcus. We compared differences in uropathogen prevalence between males and females using chi-square analysis.
Results: We identified 25,418 outpatient urinary isolates. E. coli was the most common uropathogen overall but the prevalence of E. coli was higher among females (83%) than males (50%, p <0.001). Other common species among males were Enterococcus (17%), P. mirabilis (11%) and Klebsiella (10%). However, these uropathogens each accounted for 5% or less of female isolates (p <0.001). Resistance among E. coli was highest for trimethoprim-sulfamethoxazole (24%) but lower for nitrofurantoin (less than 1%) and cephalothin (15%). Compared to 2002 Surveillance Network data, E. coli resistance rates increased for trimethoprim-sulfamethoxazole (from 23% to 31% in males and from 20% to 23% in females) and ciprofloxacin (from 1% to 10% and from 0.6% to 4%, respectively).
Conclusions: E. coli remains the most common pediatric uropathogen. Although widely used, trimethoprim-sulfamethoxazole is a poor empirical choice for pediatric urinary tract infections in many areas due to high resistance rates. First-generation cephalosporins and nitrofurantoin are appropriate narrow-spectrum alternatives given their low resistance rates. Local antibiograms should be used to assist with empirical urinary tract infection treatment.
Referred From: https://doi.org/10.1016/j.juro.2013.01.069
Author(s): Adedoyin OT, Oyeyemi BO, Aiyedehin OV
Author(s): Shaikh N, Morone NE, Bost JE, Farrell MH
Author(s): Greenhow TL, Hung YY, Herz AM, Losada E, Pantell RH
Author(s): Zorc JJ, Kiddoo DA, Shaw KN
Author(s): Habib S
Author(s): Freedman AL
Author(s): Sheikh N, Morone NE, Bost JE, Farerell MH
Author(s): Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, et al.
Author(s): Korbel L, Howell M, Spencer JD
Author(s): White B
Author(s): Nwafia IN, Ohanu ME, Ebede SO, Ozumba UC
Author(s): Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM
Author(s): Zohreh N, Alireza
Author(s): Akortha EE, Ibadin OK
Author(s): Singh SD, Madhup SK
Author(s): Matthew F. Daley, Sharisse M, Arnold R, Karen A, Glenn Liza M, et al.
Author(s): den Heijer CD, Penders J, Donker GA, Bruggeman CA Bruggeman CA, et al.
Author(s): Muoneke VU, Ibekwe MU, Ibekwe RC
Author(s): Kline KA, Lewis AL
Author(s): Gunduz, Suzan, HaticeUludaÄ?Altun
Author(s): Msaki BP, Mshana SE, Hokororo A, Hokororo A, Mazigo HD, et al.
Author(s): Nieminen O, Korppi M, Helminen M
Author(s): Sanchez GV, Baird AM, Karlowsky JA, Master RN, Bordon JM
Author(s): Bryce A, Hay AD, Lane IF, Thornton HV, Wootton M, et al.
Author(s): Elder JS
Author(s): Paulliam PN, Attia MW, Cronan KM
Author(s): Bouchillon SK, Badal RE, Hoban DJ, Hawser SP
Author(s): Ng TM, Khong WX, Harris PN, De PP, Chow A, et al.