Causative Organisms of Urinary Tract Infection in Children, and their Antibiotic Susceptibility

Kang, Yoon Duk; Kim, Nam Su; Oh, Sung Hee

Abstract

PURPOSE
In caring patients with urinary tract infection(UTI), it is prominent to know causative agents and their antimicrobial susceptibilities, of which domestic data appear somewhat different from those reported in the literature. The study was done to learn the distribution of pathogens causing UTI and their antimicrobial susceptibilities in Korean children.
METHODS
One hundred forty two inpatients diagnosed with symptomatic UTI in the Department of Pediatrics, Hanyang University Hospital from 1997 to 2002 were retrospectively enrolled to analyze relevant information obtained from medical records, including causative agents of UTI and their antimicrobial susceptibilities.
RESULTS
The average age of the study patients was 1.9 years with the peak in infants younger than 1 year of age(105 patients), of which 84 patients were younger than 6 months of age. The male to female ratio was 4:1 in <1 year of age and 1:2.1 in > or =1 year of age. Isolated organisms in urine cultures included Escherichia coli 83.1%, Klebsiella pneumoniae 6.3%, Proteus mirabilis 2.1%, and their distributions were not different, whether suprapubic specimen(100 patients) or non-suprapubic specimen(42 patients) was cultured. Antimicrobial susceptibility of E. coli was above 90% against ceftriaxone, ceftazidime, amikacin, 40-65% against trimethoprim-sulfamethoxasole, tobramycin, gentamicin, and 16.9% against ampicillin.
CONCLUSION
E. coli was isolated in 83.1% of children with UTI, which is comparable to the data in the literature. The fact that susceptibility of E. coli was low to ampicillin, gentamicin, and trimethoprim-sulfamethoxasole indicates that the empiric and prophylactic choices of antimicrobials for UTI in Korean children should be investigated further.