요로감염 환자에서 소아 및 성인의 원인균주 및 항생제내성의 차이점

Abstract

Purpose: Urinary tract infection (UTI) is one of the most common infectious diseases in children and adults. It is widely known that most UTI is caused by E. coli. In most cases for those who underwent UTIs,empirical antibiotics were treatment of choice. But resistance of empirical antibiotics is increasing gradually. The proper use of antibiotics is essential in the clinical field. We evaluated the antibiotic resistance of organisms causing UTIs in children and adults patients to provide the proper use of empirical antibiotics. Materials and Methods: From January 2011 to December 2011, 749 cases (mean age was 27.9±30.2years) who underwent positive urinary culture tests were evaluated. The age, sex, results of urine dipstick and microscopic tests, urine culture, and antibiotics resistance were reviewed. Results: 460 men and 289 women were evaluated. Adults were 310 cases (41.4%) and children were 439 cases (58.6%). Pathogens from the results of urine culture were E. coli (35.7%), Enterococcus species (25.8%), Klepsiella (12.9%). Antibiotics resistance rate of all pathogens was 29.8% and Pseudomonas (36.1%), with E. coli (32.8%) having the highest resistance rate of all. Ampicillin (61.8%), trimethoprim/sulfamethoxazole (42.6%), and penicillin (39.4%) showed higher resistance rates than other antibiotics. The multi-drug resistance rate was 17.8% in total, adults were 17.4%, and children were 18.1%. Female urine RBC and urine WBC counts were associated with UTIs from a pathogen which has resistance at to at least one of the antibiotics in adults. On the other hand, older age, urine leukocyte esterase and urine RBC count was associated with antibiotics resistance in children. Conclusions: Gram positive microorganisms including E. coli were the most common pathogen of UTIs both in adults and children. Therefore, quinolones and cephalosporins are widely used in UTIs, however antibiotic sensitivity was reduced in this study and there was no difference in adults and children. The sensitivity and drug resistance were changing steadily, affecting many factors and various pathogens gave rise to UTIs. Therefore considerations of many factors of sensitivity to antibiotics are needed.