Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital of Quito, Ecuador
Background: Urinary tract infections (UTI) are among the most common infections in pediatric patients. The main etiopathogenic agent is Escherichia coli. The purpose of this study was to determine the antimicrobial resistance pattern of E. coli in pediatric patients and to understand their main clin...
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Permanyer
2017-07-01
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| Series: | Boletín Médico del Hospital Infantil de México |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665114616301381 |
| _version_ | 1819295521563475968 |
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| author | David Garrido Santiago Garrido Miguel Gutiérrez Leonel Calvopiña Amani Sunday Harrison Michelle Fuseau Ramiro Salazar Irigoyen |
| author_facet | David Garrido Santiago Garrido Miguel Gutiérrez Leonel Calvopiña Amani Sunday Harrison Michelle Fuseau Ramiro Salazar Irigoyen |
| author_sort | David Garrido |
| collection | DOAJ |
| description | Background: Urinary tract infections (UTI) are among the most common infections in pediatric patients. The main etiopathogenic agent is Escherichia coli. The purpose of this study was to determine the antimicrobial resistance pattern of E. coli in pediatric patients and to understand their main clinical and laboratory manifestations.
Methods: Fifty-nine patients were included in the study and classified into two groups: hospitalization (H) and external consultation (EC). Every patient presented urine cultures with the isolation of E. coli that included an antibiogram. Clinical signs and symptoms, urinalysis, complete blood count (CBC) and serum inflammatory markers were analyzed.
Results: The most common clinical manifestations were fever (H: 76.5%; EC: 88%), vomiting (H: 32.4%; EC: 32%), hyporexia (H: 20.6%; EC: 16%), abdominal pain (H: 20.6%: EC: 28%), and dysuria (H: 14.7%; EC: 32%). Ten patients (16.95%) presented UTI for extended spectrum beta-lactamase (ESBL) E. coli. Ampicillin, nalidixic acid, and trimethoprim-sulfamethoxazole showed a higher resistance rate, being ampicillin the most significant (H: 88.2%; EC: 92%). Leukocyturia, bacteriuria and urine nitrites were frequent alterations in urinalysis (H: 52.9%; EC: 92%). In ESBL E. coli patients, a positive correlation was found between leukocytes in CBC and C-reactive protein (r = 0.9, p < 0.01). Diarrhea and foul-smelling urine were associated with E. coli resistance.
Conclusions: The presence of leukocytes, bacteria, nitrites and the Gram stain are the most common indicators. Nitrofurantoin and phosphomycin are good therapeutic options. However, an antibiogram must be conducted to determine the best therapeutic agent. |
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| institution | Directory Open Access Journal |
| issn | 1665-1146 |
| language | English |
| last_indexed | 2024-12-24T04:43:32Z |
| publishDate | 2017-07-01 |
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| series | Boletín Médico del Hospital Infantil de México |
| spelling | doaj.art-37de1d09c64b40c091f83f8fb0880b2d2022-12-21T17:14:45ZengPermanyerBoletín Médico del Hospital Infantil de México1665-11462017-07-0174426527110.1016/j.bmhimx.2017.02.004Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital of Quito, EcuadorDavid Garrido0Santiago Garrido1Miguel Gutiérrez2Leonel Calvopiña3Amani Sunday Harrison4Michelle Fuseau5Ramiro Salazar Irigoyen6Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, EcuadorFacultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, EcuadorServicio de Pediatría, Hospital de Especialidades de las Fuerzas Armadas N.° 1, Quito, EcuadorLaboratorio de Microbiología, Hospital de Especialidades de las Fuerzas Armadas N.° 1, Quito, EcuadorFacultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, EcuadorHospital de Especialidades de las Fuerzas Armadas N.° 1, Quito, EcuadorLaboratorio de Microbiología, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, EcuadorBackground: Urinary tract infections (UTI) are among the most common infections in pediatric patients. The main etiopathogenic agent is Escherichia coli. The purpose of this study was to determine the antimicrobial resistance pattern of E. coli in pediatric patients and to understand their main clinical and laboratory manifestations. Methods: Fifty-nine patients were included in the study and classified into two groups: hospitalization (H) and external consultation (EC). Every patient presented urine cultures with the isolation of E. coli that included an antibiogram. Clinical signs and symptoms, urinalysis, complete blood count (CBC) and serum inflammatory markers were analyzed. Results: The most common clinical manifestations were fever (H: 76.5%; EC: 88%), vomiting (H: 32.4%; EC: 32%), hyporexia (H: 20.6%; EC: 16%), abdominal pain (H: 20.6%: EC: 28%), and dysuria (H: 14.7%; EC: 32%). Ten patients (16.95%) presented UTI for extended spectrum beta-lactamase (ESBL) E. coli. Ampicillin, nalidixic acid, and trimethoprim-sulfamethoxazole showed a higher resistance rate, being ampicillin the most significant (H: 88.2%; EC: 92%). Leukocyturia, bacteriuria and urine nitrites were frequent alterations in urinalysis (H: 52.9%; EC: 92%). In ESBL E. coli patients, a positive correlation was found between leukocytes in CBC and C-reactive protein (r = 0.9, p < 0.01). Diarrhea and foul-smelling urine were associated with E. coli resistance. Conclusions: The presence of leukocytes, bacteria, nitrites and the Gram stain are the most common indicators. Nitrofurantoin and phosphomycin are good therapeutic options. However, an antibiogram must be conducted to determine the best therapeutic agent.http://www.sciencedirect.com/science/article/pii/S1665114616301381Urinary tract infectionsPediatricsEscherichia coli |
| spellingShingle | David Garrido Santiago Garrido Miguel Gutiérrez Leonel Calvopiña Amani Sunday Harrison Michelle Fuseau Ramiro Salazar Irigoyen Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital of Quito, Ecuador Boletín Médico del Hospital Infantil de México Urinary tract infections Pediatrics Escherichia coli |
| title | Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital of Quito, Ecuador |
| title_full | Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital of Quito, Ecuador |
| title_fullStr | Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital of Quito, Ecuador |
| title_full_unstemmed | Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital of Quito, Ecuador |
| title_short | Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital of Quito, Ecuador |
| title_sort | clinical characterization and antimicrobial resistance of escherichia coli in pediatric patients with urinary tract infection at a third level hospital of quito ecuador |
| topic | Urinary tract infections Pediatrics Escherichia coli |
| url | http://www.sciencedirect.com/science/article/pii/S1665114616301381 |
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