The purpose of the present study was to assess the epidemiology and resistance patterns of bacteria causing
urinary tract infections in children who were admitted to Kingston General Hospital (Kingston, Ontario) - the regional tertiary care hospital of southeastern Ontario.
METHODS: One hundred forty-two patient charts were reviewed, of which 56.3% of patients were female. The mean age of the patients was 12.3 months. The most common bacteria identified on urine culture over a five-year period were Escherichia coli (71.6%), Enterococcus species (5.7%) and Klebsiella species (5.0%). Bacteria were frequently resistant to
ampicillin (54.4%) and
trimethoprim-sulfamethoxazole (
TMP-SMX) (40.4%). During the three months before admission, bacteria resistant to
ampicillin were cultured from the urine of 75.6% of patients who were receiving some
antibiotic, compared with 44% of children with no documented use of
antibiotics (P<0.0001). Resistance to
TMP-SMX in those with pre-existing
genitourinary disease was 72.2% versus 31.8% in those without (P<0.0001). Patients who had previous admissions for
urinary tract infections also showed greater resistance to
TMP-SMX (70.6% versus 32.7%; P<0.005),
cefazolin (64.7% versus 20.0%; P<0.0001) and
nitrofurantoin (58.8% versus 18.2%; P<0.0001).
CONCLUSIONS: