Perfil de sustentabilidade antimicrobiana dos uropatógenos identificados em uroculturas de crianças no Sul do Brasil

Abstract

BACKGROUND: Urinary tract infection is one of the main morbidities in pediatric patients. Once there is clinical and laboratory suspicion, treatment should be initiated promptly with antibiotics specific to the most common pathogens, as local sensitivity patterns. OBJECTIVES: To describe the main pathogens identified in urine cultures of children with urinary tract infection and its susceptibility profile. METHODS: Cross-sectional study conducted in the Professional Master's in Women's Health, Child and Adolescent of the Catholic University of Pelotas. It was used the electronic database of the School of Clinical Analysis Laboratory, linked to the University Hospital São Francisco de Paula and Municipal Emergence Department. Results of urine cultures of children from 0 to 10 full years, collected from January/2014 to December/2015, with growth of only a single germ over 105UFC/mL were included. Simple frequency of the variables were calculated, measures of central tendency, and bivariate analyzes to compare groups were also performed. RESULTS: 3204 urine cultures were collected in the period, of which 478 were positive (14.9%). The Escherichia coli was the main bacteria identified (67%), accompanied by specimens of Proteus (12.8%) and Klebsiella (9.8%). The overall susceptibility profile showed low sensitivity to cephalothin (37%), to ampicillin (44.1%), to sulfamethoxazole-trimethoprim association (62.3%) and to nitrofurantoin (74.7%). Carbapenems, aminoglycosides, quinolones, 2nd and 3rd generation cephalosporins and amoxicillin-clavulanate presented rates above 80%. When subgroups of uropathogens were compared (E. coli versus non-E. coli), a significant difference in the sensitivity of E. coli to nitrofurantoin was noticed (p < 0.001). CONCLUSIONS: E. coli was the uropathogen most commonly found in this study. Carbapenems, aminoglycosides, quinolones, 2nd and 3rd generation cephalosporins and amoxicillin-clavulanate presented the best results of general sensitivity. In terms of cost-benefit, it should be considered as antimicrobial therapy of first orally choice amoxicillin-clavulanate and cefuroxime.