Prevalencia y resistencia contra antimicrobianos de uropatógenos bacterianos aislados de pacientes pediátricos en Venezuela.

Introduction. Infection of the urinary tract (ITU) is recognized as the second cause of bacterial infection in children. Objective. To determine the etiology and bacterial resistance of uropathogens that are being found with increasing frequency in pediatric patients, including experimental, analytical and cross sectional efforts. Materials and Methods. The research was conducted at the Laboratory for Bacteriological Diagnosis "Dr. Socrates Medina", School of Health Sciences "Francisco Battistini Casalta" of the Universidad de Oriente, Bolívar City, Bolivar State, Venezuela, between January 2007 and December 2010. Urine cultures were performed according to the calibrated loop technique, with identification by conventional methods for all urine samples. Patient samples came from inpatient and outpatient pediatric hospital patients with suspected symptoms of urinary tract infections. Antimicrobial susceptibility testing was performed using the techniques of Bauer et al. The main mechanisms of resistance were identified according to CLSI (2007) protocols. Results. UTIs were most frequently observed in preschoolers (11%) and schoolchildren (9%). Females were more affected than males, with significant statistical differences (p <0.05). 58% (n = 26/45) of patients were hospitalized, while 42% (n = 19/45) were patients from the outpatient or ambulatory clinics. The most frequent symptoms causing consultations were fever and dysuria, followed by fever and abdominal pain. Midstream urine sample collection methods were used most frequently (76%, n=33/45), followed by suprapubic aspirations (16%, n=7/45). Escherichia coli (47%, n=22/47) was the most frequently identified microbe, followed by Proteus mirabilis (11%, n=5/47). In general, E. coli infections responded well to quinolones (ciprofloxacin/ norfloxacin), and aminoglycosides such as gentamicin, nitrofurantoin and aztreonam. We found significant resistance to trimethoprim sulfamethoxazole (36%), ampicillin sulbactam (36%), and ampicillin/clavulanic acid (32%). The rest of the Gram-negative bacilli showed a similar pattern, except Enterobacter spp, who demonstrated higher levels of resistance to antibiotics, (resistance rates ranged from 45%-79%). Conclusion. Identified a high prevalence of ITU in pediatric patients. [ABSTRACT FROM AUTHOR]