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.

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1) Department of Pediatrics, Konan Kosei Hospital

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Received	September 12, 2016
Accepted	January 30, 2017

29 (1)：9─15,2017