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Clinical Features of and Antibiotic Resistance in Recurrent Urinary Tract Infection in Children with Vesicoureteral Reflux

 So Hyun Eun  ;  Ji-Man Kang  ;  Ji Hong Kim  ;  Sang Woon Kim  ;  Yong Seung Lee  ;  Sang Won Han  ;  Jong Gyun Ahn 
 Pediatric Infection & Vaccine, Vol.27(1) : 35-44, 2020-04 
Journal Title
Pediatric Infection & Vaccine
Issue Date
Urinary tract infections ; Vesico-ureteral reflux ; Child ; Anti-bacterial agents
Purpose: This study aimed to investigate the clinical features of recurrent urinary tract infection (UTI) in children with vesicoureteral reflux (VUR) and to compare the causative uropathogen and antibiotic susceptibility between the first and recurrent UTI episodes.
Methods: We retrospectively reviewed the medical records of children with VUR who had recurrent UTI. Group 1 included patients in whom the same pathogen caused the first and recurrent UTI episodes. Group 2 included patients in whom different pathogens caused the first and recurrent UTI episodes.
Results: During a 13-year study period (2005–2018), 77 children with VUR experienced at least one episode of UTI. Among these, 47 patients (61.0%) had recurrent UTI. Of the children with recurrent UTI, 19 (40.4%) were in group 1 and 28 (59.6%) were in group 2. Escherichia coli was the most commonly isolated uropathogen (n=37; 39.4%) in both episodes of recurrent UTIs, followed by Klebsiella pneumoniae (n=18; 19.1%), Enterococcus faecalis (n=14; 14.9%), and Enterobacter aerogenes (n=7; 7.4%). Although the difference was not significant, the rate of resistance to the antibiotics ceftazidime, piperacillin/tazobactam, and trimethoprim-sulfamethoxazole increased in patients with the second episode of E. coli recurrence in group 1, and that to cefotaxime, ceftazidime, piperacillin/tazobactam, and meropenem increased in children with the second episode of E. aerogenes recurrence in group 1.
Conclusions: When selecting empirical antibiotics for recurrent UTI in children with VUR, it is important to consider that the pathogen and antimicrobial susceptibility of the previous UTI are not always the same in recurrent UTIs.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Woon(김상운) ORCID logo https://orcid.org/0000-0002-5790-1948
Kim, Ji Hong(김지홍) ORCID logo https://orcid.org/0000-0001-5352-5423
Eun, So Hyun(은소현)
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
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