Cephalosporin resistant urinary tract infections in young children
Article first published online: 22 JAN 2004
Journal of Paediatrics and Child Health
Volume 40, Issue 1-2, pages 48–52, January 2004
How to Cite
Mehr, S., Powell, C. and Curtis, N. (2004), Cephalosporin resistant urinary tract infections in young children. Journal of Paediatrics and Child Health, 40: 48–52. doi: 10.1111/j.1440-1754.2004.00290.x
- Issue published online: 22 JAN 2004
- Article first published online: 22 JAN 2004
- Accepted for publication 3 June 2003.
Objective: To describe the antibiotic resistance pattern of bacteria causing urinary tract infection (UTI) in a cohort of Australian children under 6 years of age.
Methods: Data were collected over a 12-month period from children under 6 years of age with a provisional diagnosis of UTI made in the Emergency Department of Sunshine Hospital, Victoria.
Results: During the study period 100 culture-proven UTI were identified in 97 children. Three children had two episodes. Out of the 100 episodes, 39% were male, 56% were under 12 months of age at presentation and 61% were managed as outpatients. Clinical features were non-specific in the majority of cases. Hydronephrosis and vesicoureteric reflux was detected in 5.5% and 28.6%, respectively, of children with their first investigated UTI. A single bacterial isolate was cultured from 97 urines and two from three samples. Escherichia coli (n = 90) and Proteus mirabilis (n = 5) were the most common isolates. In vitro resistance to ampicillin/amoxycillin was found in 52% of isolates, to trimethoprim in 14% and to cephalothin/cephalexin in 24%. This resistance rate to first generation cephalosporins is the highest reported to date in adult or paediatric UTI in Australia.
Conclusions: Ampicillin/amoxycillin or cephalothin/cephalexin may not be the optimal choice of antibiotic for the empiric treatment of UTI in this and possibly other paediatric populations.