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Journal of the Korean Society of Pediatric Nephrology 2013;17(1): 19-24. doi: https://doi.org/10.3339/jkspn.2013.17.1.19
소아의 지역사회 획득 장구균 요로감염의 임상 양상
김성헌, 임택진, 김혜영, 박수은, 김수영
양산부산대학교 어린이병원 소아청소년과학교실
Clinical Characteristics of Community Acquired Enterococcal Urinary Tract Infections In Children
Seong Heon Kim, Taek Jin Lim, Hye Young Kim, Su Eun Park, Su Young Kim
Department of Pediatrics, Pusan National University Children’s Hospital, Pusan, Korea
Corresponding Author: Su Young Kim ,Tel: 055-360-2180, Fax: 055-360-2181, Email: suyung@pusan.ac.kr
Received: March 15, 2013;  Accepted: April 18, 2013.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons. org/licenses/bync/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Purpose: Recently, Enterococcus spp. have become one of the most common nosocomial pathogens with increasing rates of multi-drug resistance. However, study on enterococcal urinary tract infections (UTIs) in children is very limited, especially community acquired UTIs. We studied the clinical characteristics of Enterococcus spp. in community acquired UTIs and antibiotic resistance within our urban area.
All children with first episode of community acquired UTIs due to Enterococcus spp. and Echerichia coli who were admitted in Pusan National University Children’s Hospital between January 2010 and January 2013 were included in our study. We retrospectively reviewed their medical records.
Results :
During the study period, 201 patients were identified to have first episode of community acquired UTIs. 154 cases were E.coli UTIs (76.6%) and 11 cases were enterococcal UTIs (5.5%) and all Enterococcus spp. were Enterococcus feacalis. In enterococcal UTI group, voiding cystourethrogram(VCUG) was performed in 7/11 patients and demonstrated 4 vesicoureteral refluxes (VURs) with renal scar and 3 patients underwent corrective surgery. In E.coli UTI group, VCUG was performed in 121/154 patients and demonstrated 23 VURs and 11 patients underwent corrective surgery. Enterococcal group had significant high rate of underlying urinary abnormalities and surgical corrections compared with E. coli group. All Enterococcus spp. were susceptible to ampicillin, vancomycin and linezolid, but all were resistant to tetracycline. They also showed 71.4% resistance to trimethoprim-sulfamethoxazole and 20% resistance to ciprofloxacin.
Conclusion :
Community acquired enterococcal UTIs in children were rare within our urban area. However, they could be indicative of severe underlying urinary tract abnormalities.
Key words: Enterococus spp. | Community acquired UTI | Antibiotic resistance | Children | Urinary abnormality
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