All issues > Volume 49(7); 2006

Original Article

Korean J Pediatr. 2006;49(7):777-783. Published online July 15, 2006.

Susceptibility tests of oral antibiotics including cefixime against Escherichia coli, isolated from pediatric patients withcommunity acquired urinary tract infections

Soo Young SY Lee¹, Jung Hyun JH Lee¹, Jong Hyun JH Kim¹, Jae Kyun JK Hur¹, Sun Mi SM Kim², Sang Hyuk SH Ma³, Jin Han JH Kang¹

¹Department of Pediatrics, College of Medicine, The Catholic University of Korea
²Seoul SDA Hospital, Korea
³Masan Fatima Hospital†, Korea

Correspondence Jin Han JH Kang ,Email: kjhan@olmh.cuk.ac.kr

Abstract

Purpose
: Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI.
Methods
: E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line.
Results
: Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates.
Conclusion
: Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.

Keywords :Urinary tract infections , Child , Escherichia coli , Antibiotics , Microbial sensitivity tests