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19–22 APRIL, 2017, BARCELONA, SPAIN
17:14–17:17
S19-6 (PP)
CORRELATION OF CLINICAL COURSE TO ANTIBIOTIC
SUSCEPTIBILITY RESULTS OF EXTENDED SPECTRUM
BETA-LACTAMASE OF GRAM NEGATIVE BACTERIA
IN PEDIATRIC UTI PATIENTS
Chang-Hee HAN
1
, Sang-Rak BAE
1
, Jae Shin PARK
2
and Jun-Se JUNG
1
1) Uijeongbu St. Mary’s Hospital, Urology, Uijeongbu, REPUBLIC OF KOREA - 2) Daegu Catholic University Medical
Center, Department of Urology, Daegu, REPUBLIC OF KOREA
PURPOSE
This study is aimed to identify the effect of disease progression in febrile pediatric UTI patients ad-
mitted for treatment in correlation to antibiotics susceptibility of extended spectrum beta-lactamase
positive bacteria.
MATERIAL AND METHODS
In order to find correlation between antibiotic susceptibility results and clinical course a retrospective
analysis using medical records was done in 1343 febrile pediatric UTI patients admitted to the
hospital for antibiotic treatment from January 2010 to April 2015, with outcomes positive to gram
negative bacteria in urine culture. Blood tests, urine analysis, urine culture, antibiotic susceptibility
tests were identified, along with the initial antibiotics, changes in antibiotics, negative conversion
period, antibiotics susceptibility results in relation to negative conversion period, and vital signs with
other characteristics were analyzed.
RESULTS
Out of the 1343 patients admitted for febrile UTI, 67 patients were identified with ESBL positive
bacteria in their urine culture. In which 35 patients were male and 32 were female. Of the 67 patients
the number resistant to initial antibiotics were 10(14.9%). Changes in antibiotics were made in
only 2 cases, the other 8 cases did not need changes in antibiotics and negative conversion was
identified on the 2
nd
hospital date. Aminoglycoside was used in initial treatment for 63 patients out
of 67 and negative conversion was identified in all patients without using meropenem. The mean
negative conversion period was 2.25 days. Only 5 cases(7.5%) in total changed antibiotics to
meropenem or tazocin, and resulted in negative conversion in urine culture after 1 day of use.
CONCLUSIONS
Unlike adult patients, ESBL positive pediatric UTI patients showed susceptibility to aminoglyco-
sides. In cases with difficulty in identifying antibiotics susceptibility, aminoglycoside is a good choice
for initial antibiotics without the use of carbapenem or meropenem for effective treatment results.