Resistência de Escherichia coli de origem comunitária isolada do trato urinário em crianças e adolescentes do sexo feminino

Abstract

Urinary Tract Infection (UTI) is one of the most common bacterial infections in childhood and cause acute and chronic morbidity. The aim of the study was to analyze community-acquired UTI reports within female children and adolescents between 0 and 19 years of age, to assess susceptibility patterns and the evolution of Escherichia coli resistance. Method: Cross-sectional study, performed from 2011 to 2016, with the participation of four laboratories. All the positive urine cultures with the corresponding antibiogram were considered. Only the first report of each patient was included in the analysis, and the reinfection cases that occurred three or more months after the first one. Results: From the 149.179 evaluated antibiograms, 15.255 (10,22%) were positive urine cultures, of which 9.335 (89,81%) were E. coli that caused UTI in 720 (7,71%) women aged between 0 and 19 years. The highest resistance rates were the Ampicillin (57,9%) and the Trimethoprim + Sulfamethoxazole (27,5%), with progressive increase of resistance for all the evaluated antimicrobial agents. Conclusion: There was an increasing evolution resistance to the main first choice antibiotics for the community-acquired UTI treatment. Nitrofurantoin, Ampicillin + Sulbactam, Amoxicillin + Clavulanate and Amikacin are the viable alternatives for the empirical treatment of UTI caused by E. coli.