High resistance rates to 2nd and 3rd generation cephalosporins, ciprofloxacin and gentamicin of the uropathogens isolated in young infants hospitalized with first urinary tract infection
Abstract
Aims: To describe the characteristics of febrile UTI in hospitalized infants and to characterize the uropathogens distribution and antimicrobial resistance rates.
Methods: Retrospective study performed during 2010-2013, including all infants <3 months of age admitted with the diagnosis of UTI proven by urine culture obtained by bladder catheterization.
Results: 117 infants with 1st UTI episode were enrolled. There were 18 (15.39%), 57 (48.72%) and 42 (35.9%) infants aged 0-1, 1-2 and 2-3 months; 5.99% had previous renal anomalies. Fever >38°C at admission was recorded in 33 (28.2%). Leukocytosis, leukopenia and neutropenia were recorded in 20 (17.1%), 2 (1.7%) and 5 (4.3%) patients, respectively. Escherichia coli, Klebsiella spp., Enterococcus spp., Morganella morganii, Proteus spp. and Enterobacter spp. were the most common pathogens (53.3%, 10.6%, 5.2%, 5.2%, 4.5%, and 3.9% of all episodes, respectively). No differences were recorded between E. coli or Klebsiella spp.-UTI cases recorded in male vs. female patients and between the 3 age subgroups. The antibiotic resistance rates of E. coli were 61.8%, 57.4%, 50% and 45.6% for ceftriaxone, cefuroxime, gentamicin and ciprofloxacin, respectively. The antibiotic resistance rates of Klebsiella spp. were 82.9%, 80%, 54.3% and 54.3% for ceftriaxone, cefuroxime, gentamicin and ciprofloxacin, respectively. 80.9% and 42.9% of the E. coli and Klebsiella spp. isolates were ESBL-producers. The resistance rates of the 2 major pathogens…
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