Antibiotska rezistencija uzročnika infekcija urinarnog trakta kod dece

  • Sveta S Janković Klinički centar Kragujevac

Sažetak


Ciljevi: Ispitati rezistenciju uropatogena na uobičajene antibiotike koji se ordiniraju u terapiji urinarnih infekcija kod dece. Takođe, uporediti učestalost rezistencije između krajnjih tačaka ispitivanog perioda.

Metodi: U retrospektivnoj studiji analizirana je antibiotska rezistencija mikroorganizama izolovanih iz urinokultura 127 dece mlađe od 6 godina. Svi ispitanici su imali simptome i znake prve vanbolničke urinarne infekcije, zbog čega su hospitalizovani na Klinici za pedijatriju, Kliničkog centra Kragujevac u periodu između 2006. i 2010. godine.

Rezultati: Našli smo veliku učestalost rezistencije uropatogena na ampicilin (35.4%) i neznatno manju učestalost na gentamicin (33.1%) i trimetoprim-sulfametoksazol (27,6%). Identifikovana je zabrinjavajuća rezistencija na cefalosporine treće generacije (37,0%),  pri čemu je većina bakterija bila rezistentna na ceftriakson (15,7%). Takođe zabrinjava i rezistencija na cefalosporine prve generacije (29,9%), posebno na cefaleksin (26,8% od ukupnog broja izolovanih bakterija). Nije bilo značajne razlike u učestalosti rezistencije između 2006. i 2010. godine.

Zaključci: Imajući u vidu veliku rezistenciju bakterija na uobičajena antimikrobna sredstva, predlažemo češću primenu drugih ili manje korišćenih antibiotika. Amoksicilin je dobar prvi izbor kod dece starije od godinu dana sa nekomplikovanom infekcijom. Smatramo da je rezistencija na amikacin (18,9%) i ceftriakson (15,7%) prihvatljiva i da su oni još uvek dobar izbor za započinjanje parenteralne terapije posebno kod dece do godinu dana sa prvom urinarnom infekcijom, do pristizanja rezultata testova antimikrobne osetljivosti.

Ključne reči: urinarna infekcija, deca, antibiotici, rezistencija

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2014/02/21
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