[ MIC study of antibiotics used in the treatment of children with urinary tract infections caused by E.coli using E-test and its comparison with disk diffusion]

Urinary tract infection [UTI] is one of the most common bacterial infections in the childhood which could result in chronic renal failure and hypertension. Antibiotic resistance is increasing due to widely using of antibiotics. The aim of this study was to determine the MIC of antibiotics which are using in the treatment of UTI in children by E-test. In this descriptive study, 87 E.coli strains were isolated from the urine samples of the patients with UTI. E.coli antimicrobial susceptibility was determined using E-test. The MIC for each antibiotic was determined and classified using NCCLS criteria. Eighty seven urine samples were collected from 57 girls [65.5%] and 30 boys [34.5%]. The mean age for girls was 61 months and for boys was 41 months [p=0.015]. The MIC [50 and 90 percentiles] for each antibiotic was as fallow: Ampicillin [256, 256], Amikacin [1/5, 4/8], Gentamycin [0.38, 32], Nalidixic Acid [1/5, 256], Ceftriaxon [0.023, 32], Cefixim [0.19, 256] and Trimethoprim-Sulfamethoxazole [32, 32]. The antibiotic susceptibility rate for each antibiotic was as fallow: Ampicillin [21.8%], Amikacin [92%], Gentamycin [75.5%], Nalidixic Acid [64/4%], Ceftriaxon [72/4%], Cefixim [65/5%] and Trimethoprim- Sulfamethoxazole [41/4%]. This study showed that the antibiotic resistance of E.coli was very high. Due to increasing rate of E.coli resistance to Ampicillin and Cotrimoxasole in children, it is better to reconsider the empirical therapy with these antibiotics. Since in this study a lower resistance rate of E.coli was observed for Amikacin and Gentamycin therefore, we could suggest these antibiotics as alternatives in the treatment of children with urinary tract infection

[Diagnostic value of power doppler sonography in acute pyelonephritis in children]

Urinary tract infection is common in pediatric age group and can result in serious complications such as chronic renal failure and hypertension if renal parenchyma is involved. Thus, definitive diagnosis of pyelonephritis in equivocal cases is of great importance. Comparing the diagnostic value of power color Doppler sonography and DMSA scan in acute pyelonephritis in children. This was a descriptive study carried out on 80 pediatric patients [160 renal units] suspected of having pyelonephritis. Two diagnostic methods [DMSA scan and power color Doppler sonography] were performed for all patients. Assuming DMSA scan as the gold standard method in diagnosis of acute pyelonephritis, the sensitivity, specificity, positive and negative predictive values and also the accuracy of power color Doppler sonography were calculated and analyzed, statistically. Power color Doppler sonography showed a sensitivity of 66.3%, specificity of 77.5%, positive predictive value of 78.7%, and negative predictive value of 64.7% with an accuracy of 71.3% in diagnosis of acute pyelonephritis in children. The agreement between the two diagnostic tests was shown to be around 43%. Based on our data, the power color Doppler sonography of kidneys has lower sensitivity and specificity compared to those obtained by DMSA scan in diagnosing acute pyelonephritis in children and is not considered as an ideal diagnostic technique for this particular clinical condition