Clinical characteristics and antibiotic resistance of urinary tract infections in children: Escherichia. coli versus non-E. coli

Purpose: We aimed to compare the clinical features and antibiotic resistance of urinary tract infection (UTI) caused by pathogens other than E. coli (non-E. coli) with UTI caused by E. coli in children. Methods : We enrolled patients with culture-proven UTI, who were admitted to the study hospital from September 2008 to August 2009. We investigated clinical data of patients with UTI and antibiotic resistance of isolated strains. For comparison, patients were divided according by results of the urine culture into E. coli and non-E. coli UTI groups. Results : A total of 84 patients participated in this study. Twenty one cases (25.0%) were caused by non-E. coli pathogens. Frequency of non-E. coli UTI differed according to age and sex: 'male ≤6 months', 10.5%; 'male ≤6 months', 50.0%; 'female ≥6 months', 43.7%; and 'female ≥6 months', 25.0% (P =0.014). More patients who received previous antibiotic treatment (P =0.017), but fewer patients who showed hematuria (P =0.014) were included in the non-E. coli UTI group than in the E. coli UTI group. Comparison of antibiotic resistance showed that the non-E. coli UTI group possessed more strains that were resistant to cefazolin, cefotaxime, imipenem, trimethoprim/sulfamethoxazole (™P/SMZ) and tetracycline than the E. coli UTI group (P ≤0.05). Conclusion : Increased incidence, different distribution by age and sex, and high antibiotic resistance of non-E. coli UTI should be considered in selection of empirical antibiotics for treatment of UTI in children.