ABSTRACT
Background: PRONARES (Programa Nacional de Vigilancia de Resistencia) is a national surveillance program for antimicrobial susceptibility, focused in different syndromes and among these, urinary tract infections. The work is done in a laboratory net that uses common protocols and whose data are centrally analyzed using the WHONET program. Aim: To analyze the pattern of antimicrobial susceptibility of agents causing urinary infections in children in the period 1997-1999. Material and methods: In the study period, 5,525 strains were analyzed. Of these, 2,307 came from pediatric patients (1,495 hospitalized and 803 ambulatory). Results: The most common causative agent was E. coli in 74,2 percent of cases, followed by Klebsiella spp in 8,2 percent and other agents in a lower frequency. Of E. coli strains, 74 percent were resistant to ampicillin, 52 percent to clotrimoxazole and 30 percent to first generation cephalosporins. These strains were sensitive to second and third generation cephalosporins, aminoglycosides, ciprofloxacin and nitrofurantoin. Strains from nosocomial or community infections had similar antimicrobial susceptibility. Klebsiella spp had a high rate of antimicrobial resistance (over 40 percent), that was even higher among nosocomial strains. It was 90 percent susceptible to ciprofloxacin and 100 percent to imipenem. All centers from which strains came had a similar pattern of susceptibility, with the exception of a pediatric center that had significantly higher resistance levels. Conclusions: The current therapeutic recommendations for urinary tract infections in children caused by E coli, are still pertinent, but the use of first generation cephalosporins must be cautious. The treatment of Klebsiella spp requires an individual antibiogram
Subject(s)
Humans , Male , Female , Urinary Tract Infections , Drug Resistance, Microbial , Anti-Infective Agents, Urinary , Outpatients , Proteus mirabilis , Urinary Tract Infections , Chile , Longitudinal Studies , Infection Control , Escherichia coli , Klebsiella pneumoniae , Cross Infection/etiology , Cross Infection/drug therapyABSTRACT
El impétigo es una infección frecuente en la infancia. Estudios internacionales revelan cambios en los agentes causales en las últimas décadas. El objetivo de este estudio fue determinar la etiología del impétigo en un grupo de niños del área nor-poniente de Santiago. Se estudiaron en forma prospectiva 75 niños portadores de impetigo, clasificándolos según clínica en impétigos bulosos o no. Se les realizó cultivo de las lesiones, para la tipificación y estudio de sensibilidad de los agentes causales. 9 por ciento de los casos correspondieron a impétigos bulosos y en todos ellos se aisló Staphylococcus aureus. 91 por ciento presentaban impétigo no buloso, se aisló en 84 por ciento de ellos Staphylococcus aureus, en 12 por ciento Staphylococcus aureus asociado a Streptococcus pyogenes, en 3 por ciento Staphylococcus aureus asociado a Streptococcus grupo B y en 3 por ciento flora habitual de la piel. El Staphylococcus aureus fue sensible a cloxacilina, cefalosporina de 1º generación y cotrimoxazol. Se concluye que el staphylococcus aureus es el agente causal más frecuente del impétigo en niños de nuestra área y que la cloxacilina es un buen antibiótico de primera línea para su tratamiento