Abstract

HOYOS, Álvaro; SERNA, Lina; ORTIZ, Gloria  and  AGUIRRE, José. Urinary tract infection acquired in the community in pediatric patients: Clinical picture, risk factors, etiology, antibiotic resistance, and response to empirical therapy. Infect. [online]. 2012, vol.16, n.2, pp.94-103. ISSN 0123-9392.

Objectives: to describe the clinical presentation, risk factors (RF), etiology and bacterial resistance patterns in pediatric patients hospitalized with urinary tract infection from the community. Explore risk factors related with UTI by resistant bacteria. To assess the clinical response to initial empirical therapy with aminoglycosides and the institutional protocol of antibiotics in UTI front to the sensitivity of the isolations. Material and methods: cross sectional study from february/2009 to february/2011. Results: 106 patients were registered, 47 men (44,3%) vs. 59 women (55,6%). The most frequent age in both sexes was 1-12 months (63,2%). The febrile UTI was present in 78,7% of the men vs. 83,0% of the women. RF were found in 59,4% of the patients and 27,3% showed two or more. The main aetiological agents were: Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae; two and 12 isolations showed expression of extended spectrum beta-lactamases (EEβL) and β-lactamases AmpC type (presumptive), respectively. The exploratory analysis found a significantly higher frequency of antecedent of anatomic abnormalities of the kidney or urinary tract in the group of patients with UTI caused by EE β L o AmpC bacteria (p=0.0095). The last fever peak, as answer to the initial empirical therapy with aminoglycosides, occurred in the first 36 hours in the majority of the patients (87,4%) with febrile UTI, independent of resistance profile. Conclusions: Febrile ITU was the main clinical presentation. EEβL+ or AmpC+ bacteria were isolated from the community. At an institutional level the use of aminoglycosides are a good alternative for the initial treatment due to their high clinical effectiveness and low resistance profile.

Keywords : etiology; pyelonephritis; risk factor; beta -lactamases; aminoglycosides.

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