Antimicrobial resistance of urinary tract pathogens in children in Crete, Greece.

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    • Abstract:
      The aim of the present study was to identify the organisms responsible for community acquired febrile UTI in children and to investigate their susceptibility to commonly used antibiotics. A 5-y prospective analysis was performed in children hospitalized for a first episode of UTI, in Crete, Greece. A total of 262 children, 40.1% males and 59.9% females, aged 0.08 to 13 y, were enrolled in the study. Escherichia coli (E. coli) was the leading uropathogen. Antimicrobial resistance of E. coli isolates was most commonly to ampicillin (56.4%) followed by trimethoprim-sulfamethoxazole (TMP-SMX) (27.3%), cefaclor (22.5%), amoxicillin-clavulanate (15.5%), gentamicin (4.9%), cefuroxime (3.1%), nitrofurantoin (2.6%), and ceftriaxone (1.6%). Interestingly, a significant decrease in E. coli resistance to TMP-SMX was observed during the study period. Resistance to ampicillin, TMP-SMX and cefaclor was noted for 61%, 28% and 27% of the total uropathogens, respectively, making these agents inappropriate for empirical treatment of febrile UTI in our region. A larger number of pathogens may be empirically treated with amoxicillin-clavulanate. More than 90% of the uropathogens are susceptible to cefuroxime, ceftriaxone, gentamicin, and nitrofurantoin. In conclusion, several of the first-line agents for empirical treatment of childhood UTI seem to have become ineffective in the area of this study. [ABSTRACT FROM AUTHOR]
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