Antibacterial resistance patterns of pediatric community-acquired urinary infection: Overview.

BACKGROUND: Urinary tract infection (UTI) is common in children. The aim of this study was therefor to construct a guide for the empirical antibiotic treatment of community-acquired UTI by investigating the etiology and antimicrobial resistance patterns of uropathogens and analyzing the epidemiological and clinical patient characteristics. METHODS: A total of 158 children with positive urine culture were included in the study. Antibiotic susceptibility testing was performed with Vitek 2 Compact for 28 commonly used antimicrobials. RESULTS: Mean age was 3.36 ± 3.38 years (range, 45 days-15 years). Escherichia coli (60.1%), and Klebsiella spp. (16.5%) were the most common uropathogens. For all Gram-negative isolates, a high level of resistance was found against ampicillin/sulbactam (60.1%), trimethoprim/sulfamethoxazole (44.2%), cefazolin (36.2%), cefuroxime sodium (33.5%), and amoxicillin/clavulanate (31.5%). A low level of resistance was noted against cefepime (8.7%), ertapenem (4.6%), norfloxacin (1.3%), and meropenem (0.7%). There was no resistance against amikacin. CONCLUSIONS: There is high antibiotic resistance in children with UTI. The patterns of uropathogen antimicrobial resistance vary in susceptibility to antimicrobials depending on region and time. Thus, the trends of antibiotic susceptibility patterns should be analyzed periodically to select the appropriate regimen for UTI treatment.

Reference ranges of kidney dimensions in term newborns: sonographic measurements.

BACKGROUND: Ultrasonographic measurement of kidney dimensions is important in evaluation of renal disease during the neonatal period, when renal abnormalities are common and renal size rapidly changes with age. OBJECTIVE: To determine the reference ranges of kidney dimensions in newborns and to provide a reference chart for daily practice. MATERIALS AND METHODS: In this prospective study, kidney dimensions were evaluated in 385 healthy newborns with a gestational age ≥37 weeks. Each neonate seen at an obstetrics clinic and neonatal intensive care unit was examined with sonography within the first week of life. Relationships of all dimensions with gender, gestational age, height and weight were statistically analyzed. RESULTS: All dimensions of the kidneys were smaller in girls than in boys (P < 0.05). The dimensions of the left kidney were larger than those in the right kidney in both genders (P < 0.01). Longitudinal and anteroposterior dimensions of the right and left kidneys showed no correlation with the gestational age in either gender. The dimensions correlated with the height in boys (P < 0.01), while no correlation was seen between the dimensions and height in girls (P < 0.05). Weight had the best correlation with all dimensions in both genders. CONCLUSION: The reference values of kidney lengths and diagrams from this study may be useful in the sonographic evaluation of kidneys in newborns.

Antimicrobial activity of some sulfonamide derivatives on clinical isolates of Staphylococus aureus.

BACKGROUND: Staphylococcus aureus is a non-motile, gram positive, non-sporforming, facultative anaerobic microorganism. It is one of the important bacteria as a potential pathogen specifically for nosocomial infections. The sulfonamide derivative medicines are preferred to cure infection caused by S. aureus due to methicillin resistance. METHODS: Antimicrobial activity of four sulfonamide derivatives have been investigated against 50 clinical isolates of S. aureus and tested by using MIC and disc diffusion methods. 50 clinical isolate which collected from specimens of patients who are given medical treatment in Ondokuz Mayis University Medical School Hospital. A control strain of S. aureus ATCC 29213 was also tested. RESULTS: The strongest inhibition was observed in the cases of I [N-(2-hydroxy-4-nitro-phenyl)-4-methyl-benzensulfonamid], and II [N-(2-hydroxy-5-nitro-phenyl)-4-methyl-benzensulfonamid] against S. aureus. Compound I [N-(2-hydroxy-4-nitro-phenyl)-4-methyl-benzensulfonamid] showed higher effect on 21 S. aureus MRSAisolates than oxacillin antibiotic. Introducing an electron withdrawing on the ring increased the antimicrobial activity remarkably. CONCLUSION: This study may help to suggest an alternative possible leading compound for development of new antimicrobial agents against MRSA and MSSA resistant S. aureus. It was also shown here that that clinical isolates of 50 S. aureus have various resistance patterns against to four sulfonamide derivatives. It may also be emphasized here that in vitro antimicrobial susceptibility testing results for S. aureus need standardization with further studies and it should also have a correlation with in vivo therapeutic response experiments.

Reference ranges of liver and spleen dimensions in term infants: sonographic measurements.

PURPOSE: To determine reference values of ultrasonographic measurements of the liver and spleen in newborns and to provide a reference chart to use easily in daily practice. METHODS: In this prospective study, spleen and liver dimensions were evaluated in 384 healthy newborns with a gestation age ≥37 weeks in an obstetrics clinic and neonatal intensive care unit with sonography within the first week of life. Relationships of all dimensions with sex, gestational age, height, and weight were statistically analyzed. RESULTS: No statistically significant differences were found between the two sexes in any dimensions of the liver and spleen (p > 0.05). Longitudinal and anteroposterior dimensions of the liver and spleen showed no correlation with the gestational age. All dimensions of the liver and spleen showed a high correlation with the height and weight. Weight was the best correlated with all dimensions. CONCLUSION: The reference values of spleen and liver lengths and diagrams from this study may be useful in the sonographic evaluation of the spleen and liver in newborns.