بررسی مقاومت به آنتی بیوتیک ها در عفونت ادراری کودکان مبتلا به آنومالی دستگاه ادراری

Abstract

Urinary tract infection (UTI) is one of the most common infections of childhood. The first infection in females' occurs before 5 years of age and the most common age is neonatal period. At least 3% of girls and 1% of boys had a symptomatic urinary tract infection by the age of 11 years. The incidence of a first-time symptomatic urinary tract infection is highest for both genders during the first year of life. Recurrent urinary tract infections are more common in girls (up to 60-80%). The urinary tract is the most common site of E. coli and more than 90% of all uncomplicated UTIs are caused by E coli infection. Some conditions such as obstructive uropathy and voiding dysfunction are risk factors for complicated UTI. The aim of this study is to compare resistance of agents to antibiotics between complicated and simple UTI in children and determine risk factors predicting resistance of Ecoli to antibiotics. Materials and methods: In a cross-sectional study, all 2months to 14years old children with UTI who had been referred to Tabriz Pediatric Hospital during 2008-2009 evaluated using their medical records. Variables were age, sex, type of infection, first infection time, etiology, abnormality of urinary tract, prophylaxis history and antibiogram results. Data analysed by SPSS-16. Results: There were 104 patients (86.54% female and 13.46% male) included in this study. Mean age of patients was 454.11month.In 88.46%, the urine cultures were reported as Ecoli. Complicated UTIs were 61.54% while uncomplicated UTIs were 38.46%.There was statistically significant difference between complicated UTIs and uncomplicated UTIs regarding to their antimicrobial sensitivity to several agents including co-trimoxazol(p=0.001), gentamicin (p=0.01), nalidixic acid(p=0.03) and co- amoxiclave. Conclusion: Prevalence of UTI, its sex distribution age ranges and causative agents in this study are similar to other studies. But statistically significant difference between antimicrobial sensitivity complicated UTIs and uncomplicated UTIs is notable and requires more studies to define acceptable regimens for treatment of UTI., این مطالعه در نظر دارد که میزان مقاومت به آنتی بیوتیکها را در عفونتهای ادراری همراه با آنومالی و بدون آنومالی مورد مقایسه قرار داده و ریسک فاکتورهای بروز مقاومت به E.Coli را مشخص نماید .در یک مطالعه توصیفی تحلیلی مقطعی کلیه کودکان 2 ماه تا 14 سالی که از فروردین1387الی 1389 در طی 2 سال به سرویس نفرولوژی اطفال مرکز آموزشی-درمانی کودکان تبریزبا عفونت ادراری مراجعه کرده بودند وارد و بررسی شدند. متغیرهای مورد بررسی شامل : سن ، جنس ، علائم بالینی و تعداد عفونت های ادراری بودند. تعداد 104 بیمار مبتلا به UTI وارد این مطالعه شدند.از این تعداد،54/86% بیماران را دختران و 46/13% بیماران را پسران تشکیل می دادند. میانگین سن بیماران برابر با 11/445 ماه بدست آمد. . در 46/88% موارد نتایج کشت ادرار، باکتری E.Coli گزارش گردیده بود . عفونت های کمپلیکه 54/61% موارد را شامل می شدند .عفونت های غیر کمپلیکه نیز در 46/38% موارد گزارش گردیدند.