ABSTRACT
El tratamiento inicial de las infecciones del tracto urinario (ITU) es empírico por lo que es prioritario conocer la resistencia antibiótica de los microorganismos más frecuentes en una población. Además, tras la sospecha de pielonefritis aguda se debe descartar la presencia de cicatriz renal que puede dar lugar a complicaciones posteriores. Presentamos un estudio longitudinal y retrospectivo de todos los menores de 14 años diagnosticados de ITU desde el 1 de enero del 2009 hasta el 31 de diciembre del 2009. Se analizaron los datos de sensibilidad a antimicrobianos de los patógenos urinarios más importantes, el seguimiento posterior y la presencia de cicatrices. Las bacterias aisladas con mayor frecuencia fueron: Escherichia coli (80%) Proteus mirabillis (9,7%) y Klebsiella pneumoniae (4,2%). En el antibiograma, E. coli presentó una alta sensibilidad frente a fosfomicina (99,1%), cefotaxima (98,2%) cefuroxima (97,3%) y gentamicina (95,6%). La sensibilidad obtenida frente a amoxicilina-clavulánico fue del 83,2%, mientras que la obtenida frente a cotrimoxazol fue del 78,9%.Se encontraron cicatrices pospielonefríticas en el 19% de los pacientes con ITU febril, 17% de los no ingresados y 20% de los ingresados(AU)
The initial treatment of the urinary tract infections (UTI) is empirical and it is a priority to determine the antibiotic resistance of most common germs in a population. Furthermore, due to the suspicion of acute pyelonephritis the presence of renal scarring should be ruled out as this may lead to further complications. A retrospective longitudinal study was performed on all children under 14 years diagnosed with UTI from January 1 2009 to December 31 2009. The in vitro susceptibility to the most important urinary pathogens was analysed, along with the presence of scars, and a subsequent follow-up. The most frequently isolated bacteria were E. coli (80%), P. mirabilis (9.7%) and K. pneumoniae (4.2%). In the antibiogram, E coli showed a high sensitivity to fosfomycin (99.1%), cefotaxime (98.2%) cefuroxime (97.3%) and gentamicin (95.6%). The sensitivity obtained against amoxicillin-clavulanate was 83.2%, while that obtained against cotrimoxazole was 78.9%.Post-pyelonephritis scars were found in 19% of patients with febrile UTI, 17% out-patients and 20% of those admitted(AU)
Subject(s)
Humans , Male , Female , Child , Urinary Tract Infections/diagnosis , Microbial Sensitivity Tests/methods , Escherichia coli/isolation & purification , Proteus mirabilis/isolation & purification , Klebsiella pneumoniae/isolation & purification , Leukocytosis/complications , Leukocytosis/diagnosis , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Ampicillin/therapeutic use , Products with Antimicrobial Action , Urinary Tract Infections/microbiology , Longitudinal Studies/methods , Longitudinal Studies , Retrospective Studies , Microbial Sensitivity Tests , Microbial Sensitivity Tests/trends , Cicatrix/complications , Pyelonephritis/complications , Pyelonephritis/diagnosisABSTRACT
The initial treatment of the urinary tract infections (UTI) is empirical and it is a priority to determine the antibiotic resistance of most common germs in a population. Furthermore, due to the suspicion of acute pyelonephritis the presence of renal scarring should be ruled out as this may lead to further complications. A retrospective longitudinal study was performed on all children under 14 years diagnosed with UTI from January 1 2009 to December 31 2009. The in vitro susceptibility to the most important urinary pathogens was analysed, along with the presence of scars, and a subsequent follow-up. The most frequently isolated bacteria were E. coli (80%), P. mirabilis (9.7%) and K. pneumoniae (4.2%). In the antibiogram, E coli showed a high sensitivity to fosfomycin (99.1%), cefotaxime (98.2%) cefuroxime (97.3%) and gentamicin (95.6%). The sensitivity obtained against amoxicillin-clavulanate was 83.2%, while that obtained against cotrimoxazole was 78.9%. Post-pyelonephritis scars were found in 19% of patients with febrile UTI, 17% out-patients and 20% of those admitted.
