Antimicrobial Resistance Patterns Of Urinary Tract Pathogens And Rationale For Empirical Therapy In Turkish Children

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health
Article Date: 28 Sep 2008 - 1:00 PST

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UroToday.com - Dr. Ferhat Catal and his colleagues recently published a study in which they evaluated the changes in susceptibility of bacteria to commonly used antimicrobials in respect to prophylactic therapy over a six-year period. This was a retrospective analysis performed using charts of children who had had urinary tract infections and analyzing subsequent urine samples taken between January 2000-December 2006.

The study encompassed 767 UTI episodes afflicting 698 children. A total of 767 urinary bacteria were isolated from cultures taken. E. coli was the most common bacteria found, followed by Klebsiella spp. In the year 2000, almost 60% of E. coli isolates were susceptible to ampicillin and more than 40% to Bactrim. 80% of those E. coli in that year were also susceptible to gentamicin, 90% to cefuroxime and amikacin and 60% to piperacillin. By 2006 those similar strands of E. coli were more than 70% resistant to ampicillin and more than 50% resistant to piperacillin. In the year 2000, ciprofloxacin and cefuroxime were the most active agents against all the Klebsiella species. Interestingly, none of the isolates were found to be resistant to Imipenem, even as recently as 2006. Despite the fact there was some increased resistance to other antibiotics, imipenem resistance was not found.

The group concluded that prophylactic antibiotics selection should be based on what has been seen in the local prevalence of the bacterial organisms in the children of that area. It appears that resistance patterns may vary in different regions and that one must be attuned to prevalence by geographic area.

Catal F, Bavbek N, Bayrak O, Karabel M, Karabel D, Odemis E, Uz E
Int Urol Nephrol. 2008 Aug 14. Epub ahead of print.
doi:10.1007/s11255-008-9445-5

Written by UroToday.com Medical Editor Pasquale Casale, MD

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