CHANGING PATTERNS IN SENSITIVITY OF BACTERIAL UROPATHOGENS TO ANTIBIOTICS IN CHILDREN

Abstract

Objective: To determine the sensitivity/resistance of bacterial uropathogens to antibiotics in children and evaluate the changing pattern of their sensitivity over a six years period. Methodology: Medical records of children between two moths to 14 years of age who admitted with symptomatic urinary tract infection were studied in two periods: First from 2006 to 2007 and the second from 2000 to 2001 in Children's Hospital of Tabriz/Iran. The sensitivity patterns of uropathogens were compared between two periods of study. Results: The most frequently isolated germs were E.Coli, Mebsiella, enterobacter, pseudomonas aeroginosa and proteus in a descending order. In study of 2006-2007: Among the oral agents, nitrofurantoin and ciprofloxacin, and among the parenteral agents, amikacin and gentamicin had the highest activity against E.coli. The highest sensitivity of klebsiella was to ciprofloxacin, nalidixic acid, cefixime, and amikacin in a descending order. The activity of ceftriaxone, ceftizoxime, nalidixic acid and cephalexin against E.coli has decreased significantly over six years (P<0.05). Also the activity of ceftriaxone, ceftizoxime, gentamicin, amikacin and nalidixic acid against klebsiella has decreased in comparison with results of six years ago (P<0.05). There was not any significant difference in sensitivity of enterobacter and pseudomonas with results of six years ago. Conclusion: Increasing resistance of uropathogens to third generation cephatosporines and aminoglycosides raises an alarm for widespread use of these life saving drugs. The guidelines for empiric treatment of UTI should be revaluated periodically based on local studies.