The Susceptibility of Escherichia Coli to Antibiotic Treatment for Pediatric Patients With Febrile Urinary Tract Infections in the Bratislava Region

Abstract

Urinary tract infections are one of the most common types of bacterial infections in childhood. Normally, empiric antibiotic therapy is given based on local antimicrobial susceptibility. We performed a retrospective study to evaluate bacterial resistance and clinical responses to antibiotics in childhood febrile urinary tract infections (fUTIs) in the Bratislava region of Slovakia. A total of 182 children with a fUTI were enrolled in our retrospective study. 84,07% of these fUTIs were caused by pathogenic Escherichia coli (E. coli). According to microbial antibiotic susceptibility tests, the most effective antibiotic agents were third-generation cephalosporins (susceptibility was observed in 92,16% (n=141) of the cases), followed by aminopenicillins with betalactamase inhibitor (susceptibility was observed in 84,97% (n=130) of the cases) and trimethoprim-sulfamethoxazole (susceptibility was observed in 79,74% (n=122) of the cases). In contrast, E. coli was susceptible to second-generation cephalosporins in just 3,92% (n=6). Patients treated with third-generation cephalosporins achieved a clinical response to therapy almost in all of the cases (95,7% (n=66)), whereas second-generation cephalosporins were associated with a clinical response to therapy in only 55,9% (n=33) of the cases. Third-generation cephalosporins and aminopenicillins with a betalactamase inhibitor appear to be the most suitable initial antibiotic therapies in pediatric patients with fUTIs. Following current guidelines alongside the regular assessment of regional microbial antibiotic susceptibilities should provide the best treatment management for children with fUTIs.

Zusammenfassung

Harnwegsinfektionen gehören zu den häufigsten bakteriellen Infektionen im Kindesalter. Empirische antibiotische Therapie ist normalerweise verabreicht, entsprechend der lokalen antimikrobiellen Anfälligkeit. Wir haben eine retrospektive Studie durchgeführt, um die bakterielle Resistenz und das klinische Ansprechen auf Antibiotika bei febrilen Harnwegsinfektionen (fUTIs) im Kindesalter in der Region Bratislava in der Slowakei zu bewerten. 182 Kinder mit fUTI wurden in unsere retrospektive Studie aufgenommen. 84,07% aller fUTIs wurden durch pathogene Escherichia coli (E. coli) verursacht. Gemäß der mikrobiellen Antibiotika-Anfälligkeit waren Cephalosporine der dritten Generation (Anfälligkeit in 92,16% (n=141) der Fälle) die wirksamsten Antibiotika, gefolgt von Aminopenicillinen mit Betalaktamase-Inhibitor (Anfälligkeit in 84,97% (n=130) der Fälle) und Trimethoprim-Sulfamethoxazol (Anfälligkeit in 79,74 (n=122) der Fälle). E. coli war nur bei 3,92% der Fälle für Cephalosporine der zweiten Generation (n=6) anfällig. Patienten, die mit Cephalosporinen der dritten Generation behandelt wurden, erreichten in fast allen Fällen eine klinische Antibiotika-Empfindlichkeit (95,7% (n=66)). Die Cephalosporine der zweiten Generation waren bei 55,9% (n=33) mit einer klinischen Antibiotika-Empfindlichkeit verbunden. Cephalosporine und Aminopenicilline der dritten Generation mit einem Betalaktamasehemmer scheinen die am besten geeignete anfängliche Antibiotikatherapie bei pädiatrischen Patienten mit fUTIs zu sein. Die beste Behandlung bei Kindern mit fUTI sollte die Befolgung der aktuellen Leitlinien mit regelmäßiger Beurteilung der regionalen mikrobiellen Antibiotika-Empfindlichkeit sein.

Keywords

acute pyelonephritis - antibiotics - bacterial resistance - Escherichia coli - urinary tract infection

Schlüsselwörter

akute Pyelonephritis - Antibiotika - bakterielle Resistenz - Escherichia coli - Harnwegsinfektion

Publication History

Article published online:
02 August 2024

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