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  • Title: [Profile of antimicrobial resistance of agents causing urinary tract infections in Chilean children. PRONARES surveillance program].
    Author: Prado V, Trucco O, Durán C, Mamani R, Royer M, Programa Nacional de Vigilancia de Resistencia (PRONARES).
    Journal: Rev Med Chil; 2001 Aug; 129(8):877-85. PubMed ID: 11680961.
    Abstract:
    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.
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