Antibiotic Sensitivity Patterns in Children with Urinary Tract Infection: Retrospective Study Over 8 Years in a Single Center
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Purpose: We studied the pathogens and trends in antibiotic sensitivity pattern in children with urinary tract infection (UTI) over 8 years in order to evaluate adequate treatment. Methods: We performed a retrospective review of medical records of children with UTI from January 2009 to December 2016 in Daegu Fatima Hospital. Uropathogens and antibiotic sensitivity patterns were selected. Only 1 bacterial species with a colony count of ≥105 CFU/mL was considered a positive result. We compared 2 periods group (A: 2009~2012, B: 2013~2016) to investigate trends of antibiotic sensitivity pattern. Results: During the 8 year period, 589 cases are identified (E. coli was cultured in 509 cases, 86.4%). Among all patients, this study investigated the antibiotic sensitivity of E. coli . Antimicrobial susceptibility to ampicillin was steadily low for both periods (A: 32.6%, B: 40.1%, P =0.125), and to amikacin was consistently high for both periods (A: 99.4%, B: 99.3%, P =1.000). Antibiotic sensitivity to third-generation cephalosporin decreased from period A to B (A: 91.7%, B: 75.5%, P =0.000). Antibiotic sensitivity to quinolone significantly decreased from A to B (A: 88.4%, B: 78.2%, P =0.003). The prevalence of extended-spectrum β-lactamase-producing E. coli increased from period A to B (A: 6.1%, B: 17.1%, P =0.000). Conclusion: This study showed that conventional antibiotic therapy for the treatment of pediatric UTI needs to be reevaluated. A careful choice of antibiotic is required due to the change in antibiotic sensitivity and the emergence of antibiotic-resistant bacteria.
Abstract
Purpose: We studied the pathogens and trends in antibiotic sensitivity pattern in children with urinary tract infection (UTI) over 8 years in order to evaluate adequate treatment. Methods: We performed a retrospective review of medical records of children with UTI from January 2009 to December 2016 in Daegu Fatima Hospital. Uropathogens and antibiotic sensitivity patterns were selected. Only 1 bacterial species with a colony count of ≥105 CFU/mL was considered a positive result. We compared 2 periods group (A: 2009~2012, B: 2013~2016) to investigate trends of antibiotic sensitivity pattern. Results: During the 8 year period, 589 cases are identified (E. coli was cultured in 509 cases, 86.4%). Among all patients, this study investigated the antibiotic sensitivity of E. coli . Antimicrobial susceptibility to ampicillin was steadily low for both periods (A: 32.6%, B: 40.1%, P =0.125), and to amikacin was consistently high for both periods (A: 99.4%, B: 99.3%, P =1.000). Antibiotic sensitivity to third-generation cephalosporin decreased from period A to B (A: 91.7%, B: 75.5%, P =0.000). Antibiotic sensitivity to quinolone significantly decreased from A to B (A: 88.4%, B: 78.2%, P =0.003). The prevalence of extended-spectrum β-lactamase-producing E. coli increased from period A to B (A: 6.1%, B: 17.1%, P =0.000). Conclusion: This study showed that conventional antibiotic therapy for the treatment of pediatric UTI needs to be reevaluated. A careful choice of antibiotic is required due to the change in antibiotic sensitivity and the emergence of antibiotic-resistant bacteria.
참고문헌 (22)
- Brouhard BH, "Pediatrics", pp.1197~1202 (1987), Appleton & Lange Co
- Hoberman A, "Prevalence of urinary tract infection in febrile infants", J Pediatr, 123, pp.17~23 (1993)
- Elder JS, "Nelson textbook of pediatrics", pp.1829~1834 (2011), Elsevier
- Fernbach SK, "Ultrasound garding of hydronephrosis : Introduction to the system used by the society for fetal urology", Pediatr Radiol, 23, pp.478~480 (1993)
- Kang CI, "Bloodstream infections caused by antibiotic-resistant gram-negative bacilli : risk factors for mortality and impact of inappropriate initial antimicrobial therapy on outcome", Antimicrob Agents Chemother, 49, pp.760~766 (2005)
- Karami N, "Transfer of an ampicillin resistance gene between two Escherichia coli strains in the bowel microbiota of an infant treated with antibiotics", J Antimicrob Chemother, 60, pp.1142~1145 (2007)
- Yoon Kyoung Lee, "The Antibiotic Resistance Pattern of Gram-Negative Bacteria in Children Younger Than 24 Months with a Urinary Tract Infection: A Retrospective Single-Center Study over 15 Consecutive Years", Childhood Kidney Diseases, 19(2), pp.148~153 (2015), 대한소아신장학회
- 송영화, "소아 요로 감염에서 Escherichia coli에 대한 항생제 감수성의 변화에 대한 연구", Childhood Kidney Diseases, 10(2), pp.192~200 (2006), 대한소아신장학회
- 고정희, "24개월 이상 소아에서 요로 감염의 원인균과 항생제 감수성의 양상 : 6년간 단일 기관 경험", Clinical and Experimental Pediatrics, 52(10), pp.1147~1152 (2009), 대한소아청소년과학회
- Zhanel GG, "Antibiotic resistance in Escherichia coli outpatient urinary isolates : final results from the North American Urinary Tract Infection Collaborative Alliance(NAUTICA)", Int J Antimicrob Agents, 27, pp.475~488 (2006)
- 장민기, "전북대학교병원에서 분리된 그람음성균의 항생제 내성률의 변동과 약물 사용과의 관계", Clinical and Experimental Pediatrics, 43(5), pp.625~631 (2000), 대한소아청소년과학회
- Ji Eun Yoon, "Antibiotic susceptibility and imaging findings of the causative microorganisms responsible for acute urinary tract infection in children: a five-year single center study", Clinical and Experimental Pediatrics, 54(2), pp.79~85 (2011), 대한소아청소년과학회
- Yun KW, "Principles of antibiotic therapy in pediatric emergency department", Pediatr Emerg Med J, 2, pp.59~66 (2015)
- 김서희, "항생제 사용량 변화에 따른 그람음성균주의 항생제 내성률의 변화 양상", Pediatric Infection and Vaccine, 22(3), pp.178~185 (2015), 대한소아감염학회
- 허재균, "소아에서 fluoroquinolone 사용", Clinical and Experimental Pediatrics, 51(10), pp.1042~1046 (2008), 대한소아청소년과학회
- Aihua Wang, "Presence of qnr gene in Escherichia coli and Klebsiella pneumoniae resistant to ciprofloxacin isolated from pediatric patients in China", BMC Infectious Diseases, 8, pp.68~ (2008)
- Du Bois SK, "TEM-and SHV-derived extended-spectrum beta-lactamase : Relationship between selection, structure and function", J Antimicrob Chemother, 35, pp.7~22 (1995)
- Pai H, "The characteristics of extended-spectrum beta-lactamases in Korean isolates of Enterobacteriaceae", Yonsei Med J, 39, pp.514~519 (1998)
- 이정원, "지역사회 획득 소아 요로검염에서 Extended-Spectrum b-Lactamase 생성 Escherichia coli의 발생과 위험인자", Childhood Kidney Diseases, 8(2), pp.214~222 (2004), 대한소아신장학회
- 박철, "발열성 소아 요로감염에서 Extended-Spectrum β- Lactamase 생성 Escherichia coli의 임상적 의의", Childhood Kidney Diseases, 16(1), pp.38~45 (2012), 대한소아신장학회[DOI]
- 안도희, "Extended-Spectrum β-Lactamase 생성 균주와 비생성 균주에 의한 지역사회 획득 요로 감염 비교", Pediatric Infection and Vaccine, 22(1), pp.29~35 (2015), 대한소아감염학회
- 김남희, "Extended-Spectrum β - Lactamase 생성 Escherichia coli에 의한 소아 요로감염의 위험인자", Clinical and Experimental Pediatrics, 47(2), pp.164~169 (2004), 대한소아청소년과학회