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Antibiotic Resistance Rising in Kids with Urinary Tract Infections

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Urinary Tract Infections (UTI) affect about 3 percent of children in the United States each year and account for more than 1 million visits to a pediatrician.

The most common cause of a UTI is the bacterium E.coli, which normally lives in the large intestine and are present in a child’s stool. The bacterium enters the urethra and travels up the urinary tract causing an infection. Typical ways for an infection to occur is when a child’s bottom isn’t properly wiped or the bladder doesn’t completely empty.

Problems with the structure or function of the urinary tract commonly contribute to UTIs in infants and young children.

UTIs are usually treated with antibiotics but a new scientific review warns that many kids are failing to respond to antibiotic treatment.

The reason, according to the researchers, is drug resistance following years of over-prescribing and misusing antibiotics.

"Antimicrobial resistance is an internationally recognized threat to health," noted study author Ashley Bryce, a doctoral fellow at the Center for Academic Primary Care at the University of Bristol in the U.K.

The threat is of particular concern among the younger patients, the authors said, especially because UTIs are the most common form of pediatric bacterial infections.

Young children are more vulnerable to complications including kidney scarring and kidney failure, so they require prompt, appropriate treatment, added Bryce and co-author Ceire Costelloe. Costelloe is a fellow in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, also in the U.K.

"Bacterial infections resistant to antibiotics can limit the availability of effective treatment options," ultimately doubling a patient's risk of death, they noted.

The study team reviewed 58 prior investigations conducted in 26 countries that collectively looked at more than 77,000 E. coli samples.

Researchers found that in wealthier countries, such as the U.S., 53 percent of pediatric UTI cases were found to be resistant to amoxicillin, one of the most commonly prescribed primary care antibiotics. Other antibiotics such as trimethoprim and co-amoxiclav (Augmentin) were also found to be non-effective with a quarter of young patients resistant and 8 percent resistant respectively.

In poorer developing countries, resistance was even higher at 80 percent, 60 percent respectively and more than a quarter of the patients were resistant to ciprofloxacin (Cipro), and 17 percent to nitrofurantoin (Macrobid)).

The study team said they couldn’t give a definitive reason about cause and effect but said the problem in wealthier countries probably relates to primary care doctors' routine and excessive prescription of antibiotics to children.

In poorer nations, "one possible explanation is the availability of antibiotics over the counter," they said, making the medications too easy to access and abuse.

"If left unaddressed, antibiotic resistance could re-create a world in which invasive surgeries are impossible and people routinely die from simple bacterial infections," they added.

In an accompanying editorial, Grant Russell, head of the School of Primary Health Care at Monash University in Melbourne, Australia, said the only surprise was the extent of the resistance and how many first-line antibiotics were likely to be ineffective.

If current trends persist, he warned, it could lead to a serious situation in which relatively cheap and easy-to-administer oral antibiotics will no longer be of practical benefit to young UTI patients. The result would be a greater reliance on much more costly intravenous medications.

The problem of antibiotic resistance for bacterial infections has been on the minds of scientist for some time now.  Cases are increasing at an unprecedented rate causing alarm and a call for more public education and due diligence on the part of physicians that prescribes antibiotics.

Story source: Alan Mozes, http://www.webmd.com/children/news/20160316/antibiotic-resistance-common-in-kids-urinary-tract-infections

 

 

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