ESPN 54th Annual Meeting

ESPN 2022


 
CHANGES IN ANTIBIOTIC RESISTANCE IN CHILDREN WITH THE FIRST FEBRILE URINARY TRACT INFECTION IN LAST TWO DECADES
ANA PETROVIC 1 SRDJAN NIKOLOVSKI 1 DUSAN PARIPOVIC 1 GORDANA MILOSEVSKI LOMIC 1 MILICA VUKANOVIC 1 BRANKICA SPASOJEVIC 1 MIRJANA KOSTIC 1

1- UNIVERSITY CHILDRENS HOSPITAL - TIRSOVA
 
Introduction:

Urinary tract infection (UTI) is one of the most common childhood diseases and causes of antibiotic prescriptions. Antibiotic treatment is usually initiated empirically, based on symptomatology, blood and urine analysis, knowing the potential pathogen distribution and sensitivity patterns in population. However, resistance patterns should be monitored regularly in order to keep guidelines up to date. The aim of this study was to assess and compare antibiotic sensitivity and resistance patterns during 2005-2011 and 2017-2021.

Material and methods:

We retrospectively reviewed hospital records for patients aged 1 months to 3 years, who were discharged from Nephrology department, with a principal diagnosis of the first febrile UTI, during the two study periods: January 1st, 2005 – December 31st, 2011 (Group 1) and January 1st, 2017 – June 30th, 2021 (Group 2). Urine samples from each patient were obtained at admission before initiating antimicrobial therapy. Urine culture and antibiogram results were analysed. Antibiotic resistance rates were checked for: ampicillin, ceftriaxone, ciprofloxacin, nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-SMX), gentamicin, amikacin, ceftazidime and imipenem.

Results:

A total of 690 patients were included in the study, 502 (72.8%) in Group 1 and 188 (27.2%) in Group 2. The median age of all patients was 0.4 (IQR 0.3-0.8) years. E. coli was the most common isolated pathogen taking place in 591/690 cases. Significantly higher antibiotic resistance rates of E. coli isolates were observed with ciprofloxacin, gentamicin and amikacin in Group 2, compared to Group 1. Decrease of resistance rates to TMP-SMX was recorded in Group 2, compared to Group 1. No significant changes in resistance rates to ampicillin, ceftriaxone, nitrofurantoin, ceftazidime and imipenem were noticed. 

Conclusions:

Comparing two study periods, resistance to ciprofloxacin, gentamicin and amikacin have increased during time, while resistance to TMP-SMX has decreased. Our findings support the need for periodical assessment of antibiotic resistance.