Antimicrobial resistance among Escherichia coli that cause childhood community-acquired urinary tract infections in Northern Italy

Abstract

AbstractsBackgroundResistance rate of Escherichia coli against antimicrobials that are commonly prescribed in pediatric urinary tract infections is currently a matter of concern.MethodsThe antimicrobial susceptibility patterns of uropathogenic Escherichia coli strains to the common antibimcrobials ampicillin, cotrimoxazole, coamoxyclav, ceftazidime, ceftriaxone, nitrofurantoin, and gentamycin were determined in 177 children aged from 2 to 36 months. They presented with their first symptomatic community acquired urinary tract infection at the Department of Pediatrics, San Leopoldo Mandic Hospital, Merate-Lecco.ResultsHigh rates of ampicillin (inpatients: 50%; outpatients: 52%) resistance were identified. The resistance for cotrimoxazole (inpatients: 22%; outpatients: 15%) and especially coamoxyclav (inpatients: 6%; outpatients: 10%) was less pronounced than that to ampicillin. No resistance or less than 1% of resistance was identified for ceftazidime, ceftriaxone, nitrofurantoin, and gentamycin both in inpatients and in outpatients.ConclusionsItalian children affected with a community acquired urinary tract infection are initially managed orally with coamoxyclav or parenterally with ceftriaxone. The results of the present retrospective analysis support this attitude. Parenteral ceftriaxone or an aminoglycoside should be considered for patients on antimicrobial prophylaxis or recently prescribed antimicrobials.

High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

“…In recent years, extended-spectrum β-lactamases (ESBLs) have increased in type and frequency, such as enterobacteriaceae and carbapenemases, which have resulted in a worldwide dissemination of such extended spectrum β-lactamases producing strains [21]; production of extended spectrum β-lactamases (ESBLs) is currently a matter of increasing global concern [5,22]. Ruppe and Cols identified that the occurrence of UTI caused by ESBL E. coli in women who were not exposed to antibiotics was linked to the relative amount of fecal ESBL E. coli [23].…”

“…Because most UTIs are generally treated empirically, the selection of antimicrobial agent should be determined not only by the most common pathogen, but also from consideration of risk factors that may alter that pathogen´s typical susceptibility profile. One such risk factor is the production of extended spectrum beta lactamases [5,7]. The acquisition of such beta lactamases may be related to changes in the bacterial genome by mutation or acquisition by horizontal transfer of extrachromosomal genetic material [8,9].…”

“…UTIs are one of the most common bacterial infections occurring in children and the most common bacterial infection diagnosed in women [2,5,6]. Prompt recognition and correct antimicrobial management can relieve symptoms and prevent more serious sequelae, such as progressive kidney damage [5,6]. Most UTIs (85%) are caused by Escherichia coli (E. Coli) and Staphylococcus saprophyticus (10%), with Klebsiella pneumoniae and the Proteus species accounting for the majority of the remaining etiologic agents [1].…”

“…UTIs have been reported to affect up to 150 million individuals annually worldwide [1][2][3] and contribute to >30% of health-care facility associated infections, as annually reported by acute care hospitals [4]. UTIs are one of the most common bacterial infections occurring in children and the most common bacterial infection diagnosed in women [2,5,6]. Prompt recognition and correct antimicrobial management can relieve symptoms and prevent more serious sequelae, such as progressive kidney damage [5,6].…”

Antibiotic Resistance of Isolated Gram Negative Bacteria From Urinary Tract Infections (UTIs) in Isfahan

“…Despite extensive use of FM for many years, this antibiotic still possesses an excellent activity against urinary isolates of E. coli (6,7,11,16,17,19); however, compared with fluoroquinolones, the FM is associated with lower treated rates and more side effects in the treatment of acute cystitis (11,18); also, this antibiotic was poorly tolerated by children and old patients and cannot be used for pyelonephritis (5). In our study, after FM, the E. coli isolates were showing the least resistance to CTX.…”