Perfil de resistencia a los antimicrobianos en agentes causantes de infección del tracto urinario en niños chilenos: Programa de vigilancia PRONARES

• Valeria Prado J ^[1] ; Olivia Trucco A ; Claudia Durán T ; Rosana Mamani J ; Michel Royer F
  1. [1] Programa de Microbiología
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 129, Nº. 8, 2001, págs. 877-885
• Idioma: español
• Títulos paralelos:
  • Antimicrobial susceptibility of agents causing urinary tract infections in children: PRONARES surveillance program
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• Resumen

  • Background: PRONARES (Programa Nacional de Vigilancia de Resistencia) is a national surveillance program for antimicrobial susceptibility, focused in different syndromes and among these, urinary tract infections. The work is done in a laboratory net that uses common protocols and whose data are centrally analyzed using the WHONET program. Aim: To analyze the pattern of antimicrobial susceptibility of agents causing urinary infections in children in the period 1997-1999. Material and methods: In the study period, 5,525 strains were analyzed. Of these, 2,307 came from pediatric patients (1,495 hospitalized 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 strains were sensitive to second and third generation cephalosporins, aminoglycosides, ciprofloxacin and nitrofurantoin. Strains from nosocomial or community infections had similar antimicrobial susceptibility. Klebsiella spp had a high rate of antimicrobial resistance (over 40%), that was even higher among nosocomial strains. It was 90% susceptible to ciprofloxacin and 100% to imipenem. All centers from which strains came had a similar pattern of susceptibility, with the exception of a pediatric center that had significantly higher resistance levels. Conclusions: The current therapeutic recommendations 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 Méd Chile 2001; 129: 877-885).