The Distribution of Community-Acquired Gram Negative Microorganisms Isolated From the Urine Samples of Children, and the Evaluation of Increase in Antibiotic Resistance Between the Years 2003-2010

Abstract

Aim: Appropriate antibiotic use for urinary tract infection (UTI) will provide protection against antibiotic resistance and complications including renal parenchimal damage and reflux nephropathy which may occur in the future. This study aimed to show the distrubition of community-acquired gram negative microorganisms in the region of Konya and the change in antibiotic resistance rates in time. Material and Method: Patients between 0 and 17 years of age with a positive urine culture between July 2003 and January 2010 were included in the study. 2544 positive cultures were obtained from a total of 1742 patients. Results: Female patients costituted 57.6 % of the patients who had positive urine culture. Microorganisms isolated from infected female and male patients included E coli (76.1 and 41.9%), Klebsiella spp (13.7 and 24.3%), Proteus spp (6.9 and 28.4%) and the others (3.4 and 5.2%). E.coli, Klebsiella and Proteus species were found to be sensitive to carbapenems, aminoglycosides, quinolones and third generation cephalosporines. High trimetoprim-sulphametoxasol (TMP-SM) resistance in the E.coli and Proteus groups (48.2%-48.5%) and high ampicillin resistance (68.9-88.2%) in the E.coli and Klebsiella groups were remarkable. For all three microorganisms an amikacin sensitivity of 100% was found. When antibiotic sensitivities were compared between the periods of 2003-2006 and 2006-2010, resistance rates of microorganisms against many antibiotics were found to be increased significantly. Conclusions: These data suggested that the microorganisms causing UTI were susceptible to aminoglycosides and third generation cephalosporins. The apparent increase in the resistance rates over a relatively short period was a precarious circumstance. Trimethoprim-sulphamethoxazole and ampicilline should not be the first choice for treatment of UTI because of high resistance rates.