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Article in Japanese

Causative strains and antimicrobial susceptibility profiles in pediatric upper urinary tract infections during the past 7 years

Naozumi FUJISHIRO1), Naoko NISHIMURA1), Shuta KITO1), Kazunori HARUTA1), Kei KOZAWA1), Masahiro KAWAGUCHI1), Tomoyasu NOGUCHI1), Kensei GOTOH1), Koji TAKEMOTO1), Takao OZAKI1)

Ninety seven children were admitted to this hospital with upper urinary tract infections from April 2008 to March 2015. Among them, 9 had repeated hospitalization. The 88 remaining children comprised 51 boys and 37 girls, with a median age at initial admission of 5 months (15 days-15 years and 5 months). Pyuria and vesicoureteral reflux was noted in 77% and 45% of the children, respectively. Escherichia coli was the most common isolate, accounting for 70% of all of the 97 strains isolated, followed by Enterococcus faecalis (13%) and Klebsiella pneumoniae (5%). Among the E. coli strains, 43% and 25% demonstrated resistance to ampicillin and cefditoren or cefdinir, respectively. Furthermore, 10% of E. coli strains and 20% of K. pneumoniae strains produced extended spectrum beta lactamase (ESBL). Among 8 patients from whom ESBL-producing strains were isolated, 4 had their first episode and no underlying urinary tract diseases, while the remaining 4 had underlying diseases. When comparing results of this surveillance with those from a previous one by these authors during 2004-2006, resistance to oral cephem antimicrobials had increased. In addition, ESBL-producing strains were detected this time, although they were not found previously. These findings suggest a trend of increased antimicrobial resistance among causative strains.

1) Department of Pediatrics, Konan Kosei Hospital

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Received September 12, 2016
Accepted January 30, 2017

29 (1):9─15,2017