Antimicrobial susceptibility of agents causing urinary tract infections inchildren. PRONARES surveillance program

Background: PRONARES (Programa Nacional de Vigilancia Cie Resistencia) is a national surveillance Program for antimicrobial susceptibility, focused in different among these, urinary, tract infections. The work, is done in a l aboratory net that uses Common protocols and whose data are centrally analy zed using the WHONET program, Aim: To analyze the pattern of antimicrobial susceptibility of agents causing urinary infections in children in the peri od 1997-1999, Material and methods: fit the study period, 5,525 strains wer e analyzed. Of these, 2,307 came from pediatric patients (1,495 bospitalize d and 803 ambulatory). Results: The most common causative agent was E. coli in 74,2% of cases, followed by Klebsiella spp in 8,2% and other agents in a lower frequency. Of E. coli strains, 74% were resistant to ampicillin, 52 % to clotrimoxazole and 30% to first generation cephalosporins. These strai ns were, sensitive to second aad third generation cephalosporins, aminoglyc osides, ciprofloxacin and nitrofurantoin. Strains from nosocomial or commun ity infections had similar antimicrobial susceptibility. Klebsiella spp had a high rate of antimicrobial resistance (over 40%), that was even higher a mong nosocomial strains. It was 90% Susceptible to ciprofloxacin and 100% t o imipenem. All centers from which strains came had a similar pattern of su sceptibility, with the exception of a pediatric center that had significant ly higher resistance levels. Conclusions: The current therapeutic recommend ations for urinary tract infections in children Caused by E Coli, are still pertinent, but the use of first generation cephalosporins must be cautious . The treatment of Klebsiella spp requires an individual antibiogram (Rev M ed Chile 2001; 129: 877-885).