The Change of Antibiotic Susceptibility in Febrile Urinary Tract Infection in Childhood and Adolescence During the Last Decade

Overview

Journal Investig Clin Urol

Specialty Urology

Date 2022 Jan 4

PMID 34983128

Citations 3

Authors

Useok Choi

Eunjae Kim

Don Hee Lyu

Kang Seob Kim

Bong Hee Park

Hong Chung

Chang Hee Han

Sangrak Bae

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to clarify the pattern of antibiotic resistance in pediatric urinary tract infections (UTIs).

Materials And Methods: We analyzed the data of entire urine culture tests and antibiotic susceptibility tests performed on hospitalized patients for febrile UTI at the Uijeongbu St. Mary's Hospital during 2010-2020. A retrospective analysis was performed using medical records of urine culture results and antibiotic susceptibility results in patients with UTIs.

Results: We performed urine cultures from 2,491 patients, and identified bacterial types in 1,651 cases. We found that the resistance rates to ampicillin, ampicillin/sulbactam, cefazolin, gentamicin, piperacillin, tobramycin, and trimethoprim/sulfamethoxazole were already over 20% in 2010. The resistance rates to many other antibiotics also steadily increased over time. Among the antibiotics tested in 2020, only amikacin, cefoxitin, imipenem, piperacillin/tazobactam, and tigecycline showed the resistance rates below 20%. Noticeably, ciprofloxacin also showed an increase in the resistance rate from 7.3% in 2010 (S 139 vs. R 11) to 27.78% in 2019 (S 104 vs. R 40) and even over 30% (33.96%) in 2020 (S 35 vs. R 18).

Conclusions: Antibiotic resistance is a serious problem in pediatric UTIs. In the treatment of pediatric UTIs, more caution is needed in the use of antibiotics. It may be necessary to apply appropriate antibiotic management programs such as antibiotics steward program for pediatric patients. Failure of a proper response strategy coping with antibiotic resistance may accelerate the resistance crisis.

Citing Articles

Nationwide surveillance of antimicrobial resistance for uncomplicated cystitis in 2023: Conducted by the Korean Association of Urogenital Tract Infection and Inflammation.

Yu S, Jung S, Lee S, Oh M, Choi J, Choi C Investig Clin Urol. 2025; 66(2):161-171.

PMID: 40047130 PMC: 11885923. DOI: 10.4111/icu.20240302.

Antimicrobial Resistance of for Uncomplicated Cystitis: Korean Antimicrobial Resistance Monitoring System.

Yu S, Jung S, Lee S, Oh M, Choi J, Choi C Antibiotics (Basel). 2024; 13(11).

PMID: 39596768 PMC: 11591001. DOI: 10.3390/antibiotics13111075.

Piperacillin-Tazobactam versus Cefotaxime as Empiric Treatment for Febrile Urinary Tract Infection in Hospitalized Children.

Han K, Oh M, Ahn J, Lee J, Kim Y, Yoon Y Infect Chemother. 2024; 56(2):266-275.

PMID: 38960740 PMC: 11224032. DOI: 10.3947/ic.2024.0020.

Urinary Tract Infection and Antimicrobial Resistance Patterns: 5-Year Experience in a Tertiary Pediatric Nephrology Center in the Southwestern Region of Poland.

Kawalec A, Jozefiak J, Kilis-Pstrusinska K Antibiotics (Basel). 2023; 12(9).

PMID: 37760750 PMC: 10525788. DOI: 10.3390/antibiotics12091454.

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