مقاومت آنتي بيوتيكي عفونتهاي ادراري در كودكان تحت دياليز صفاقي مراجعه كننده به مراكز درماني كودكان مفيد و لبافي نژاد

Antimicrobial Resistance of Urinary Tract Pathogens in Children on Peritoneal Dialysis

Background and objective: The changing pattern of antimicrobial resistance in the causative microorganisms of urinary tract infections (UTIs) in childhood is a growing problem. Regarding high prevalence of UTIs in children, various differential diagnosis and also host factors as dialysis, antimicrobial resistance assigning for proper treatment seems essential. THE AIMS of this study were to assess the kind of isolated bacterial strains and their current drug sensitivity to commonly used antimicrobials in children with terminal renal failure on peritoneal dialysis (PD) treatment who suffer from UTI. Materials and methods: The study included 50 children (6 months -17 years) on PD for period 6 months. In the first phase of our study, we collected the culture results of all midstream urine specimens submitted from Labbafmejad and Mofid children hospitals, to the clinical bacteriology laboratory at the Pediatric Infectious Research Center for culture and susceptibility testing from March to September 2006. Total number of 34 culture-positive UTI episodes were recorded (26 in girls, 8 in boys). From 34 positive cultures 36 microorganisms were isolated. Results: The most frequent occurring pathogen was Escherichia coli(75%).; Enterococcus(8.3%), Staphylococcus epidermidis(8.3%), Kingella spp(2.8%), yeast(2.8%) and fungus(2.8%) are known as other important causative microorganisms respectively. Gram negative strains shown maxinum resistance to Amoxicillin (71.46%) & Cotrimoxazole (57.1%) and minimum resistance to Amikacin (7.1%) & Nitrofurantoin (21.4%). Gram positive strains shown maximum resistance to Cefixim (100%), Cotrimoxazole(83.3%)& Cefazolin (83.3%), and minimum resistance to Amikacin (33.3%).E. COLI strains revealed most resistancy to Amoxicillin and Cotrimoxazole. Conclusion: E. coli strains revealed most resistancy to Amoxicillin and Cotrimoxazole. It seems the diagnosis of pathogen and antibiogram is very important before treatment of UTI especially in high risk patients.