Can We Predict Antibiotic-resistance in Urinary Tract Infection.

ABSTRACT

In this study, 769 children (age 2-71 mo) enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) or Careful Urinary Tract Infection Evaluation (CUTIE) studies were included to determine the risk factors of having pathogens resistant to narrow spectrum antimicrobials in urinary tract infection (UTI). The authors used logistic regression models to test the associations between demographic and clinical characteristics and resistance to narrow spectrum antimicrobials. Of the included patients, 91% were females, and 76% had vesicoureteral reflux. The odds of resistance to narrow-spectrum antibiotics in uncircumcised males were approximately 3 times that of females (OR 3.1; 95% CI 1.4, 6.7); in children with bladder bowel dysfunction, the odds were 2 times that of children with normal function (OR 2.2; 95% CI 1.2, 4.1). Children who had received one course of antibiotics during the past 6 months also had higher odds of harboring resistant organisms (OR 1.6; 95% CI 1.1, 2.3). Hispanic children had higher odds of harbouring pathogens resistant to some narrow-spectrum antimicrobials. The authors concluded that uncircumcised males, hispanic children, children with bladder bowel dysfunction, and children who received a course of antibiotics in the past 6 months were more likely to have a urinary tract infection caused by pathogens resistant to one or more narrow-spectrum antimicrobials.