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International Urology and Nephrology

, Volume 43, Issue 2, pp 549–555 | Cite as

Antimicrobial susceptibility of pediatric uropathogens in Thrace, Greece

  • Elpis MantadakisEmail author
  • Aggelos Tsalkidis
  • Maria Panopoulou
  • Spyridon Pagkalis
  • Gregory Tripsianis
  • Mathew Falagas
  • Sophia Kartali-Ktenidou
  • Athanassios Chatzimichael
Nephrology – Original Paper

Abstract

The aim of this study was to investigate the bacterial pathogens involved in pediatric urinary tract infections (UTIs) in a tertiary general hospital located in the Thrace province of Northern Greece over a 69-month period (1/2003 to 9/2008), and their antibiotic susceptibility patterns. A total of 622 episodes of UTIs in 508 children were identified. Median age of all children was 16 months (range 1 month to 14 years). Boys were significantly younger than girls (9 months vs. 24 months). Escherichia coli was the most common uropathogen and responsible for 69.1% of UTIs. Approximately half of E. coli isolates were resistant to ampicillin and 20.5% to trimethoprim/sulfamethoxazole (TMP/SMX). E. coli resistance to second-generation and third-generation cephalosporins was <4%, to aminoglycosides <8%, and to nitrofurantoin 4.4%. Pediatric E. coli urine isolates were significantly more resistant to ampicillin and ticarcillin and more sensitive to quinolones compared to adult E. coli uropathogens identified in the same hospital. E. coli resistance to ampicillin and amoxicillin/clavulanic acid was significantly higher in boys 12–23 months-old compared to girls of the same age. In conclusion, nitrofurantoin is a very good choice for chemoprophylaxis. Amoxicillin/clavulanic acid, second-generation cephalosporins, and TMP/SMX are appropriate choices for oral empirical treatment of UTIs. Parenteral aminoglycosides and second and third-generation cephalosporins are excellent treatment choices for inpatient therapy. Finally, sex and age are additional factors that should be taken into account when choosing empirical therapy for children with UTIs.

Keywords

Antibiotic susceptibilities Children Escherichia coli Greece urinary tract infections 

Abbreviations

UTI(s)

Urinary tract infection(s)

ASP

Antibiotic Susceptibility Patterns

UGDHA

University General District Hospital of Alexandroupolis

CFU(s)

Colony forming unit(s) MICs, minimal inhibitory concentrations

TMP/SMX

Trimethoprim/sulfamethoxazole

CLSI

Clinical and Laboratory Standards Institute

Notes

Conflicts of interest statement

None.

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Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • Elpis Mantadakis
    • 1
    Email author
  • Aggelos Tsalkidis
    • 1
  • Maria Panopoulou
    • 4
  • Spyridon Pagkalis
    • 1
  • Gregory Tripsianis
    • 3
  • Mathew Falagas
    • 2
  • Sophia Kartali-Ktenidou
    • 4
  • Athanassios Chatzimichael
    • 1
  1. 1.Department of PediatricsUniversity General District Hospital of Alexandroupolis and Democritus University of Thrace Medical SchoolAlexandroupolis, ThraceGreece
  2. 2.Alfa Institute of Biomedical Sciences (AIBS)Athens, Greece, and Tufts University School of MedicineBostonUSA
  3. 3.Department of BiostatisticsUniversity General District Hospital of Alexandroupolis and Democritus University of Thrace Medical SchoolAlexandroupolis, ThraceGreece
  4. 4.Laboratory of MicrobiologyUniversity General District Hospital of Alexandroupolis and Democritus University of Thrace Medical SchoolAlexandroupolis, ThraceGreece

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