Related Experiment Video
Updated: Aug 15, 2026
Establishment and Characterization of UTI and CAUTI in a Mouse Model
Published on: June 23, 2015
Antibiotic resistance patterns in children hospitalized for urinary tract infections
Stephanie A Lutter1, Melissa L Currie, Lindsay B Mitz
1Division of Nephrology, Department of Pediatrics, Medical College of Wisconsin and Children's Research Institute of Children's Hospital of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
Insights
Children receiving prophylactic antibiotics for urinary tract infections (UTIs) face higher resistance to common intravenous antibiotics. Aminoglycosides are recommended over third-generation cephalosporins for these patients.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance
- Urinary tract infections
Background:
- Limited data exists on antibiotic resistance patterns in pediatric hospital-acquired urinary tract infections (UTIs).
- Risk factors for increased bacterial resistance in children with UTIs require further investigation.
Purpose of the Study:
- To determine antibiotic resistance patterns in hospitalized children with UTIs.
- To identify if prior UTI, antibiotic prophylaxis, or vesicoureteral reflux are risk factors for resistant infections.
Main Methods:
- Retrospective review of 361 pediatric UTI cases admitted over 5 years.
- Data collected included patient demographics, culture and sensitivity results, and medical history.
- Analysis focused on identifying pathogens and resistance to common intravenous antibiotics.
Main Results:
- Escherichia coli was the predominant pathogen (87%).
- Children on prophylactic antibiotics or with a history of UTI had lower rates of E. coli infections.
- Resistance to cefotaxime sodium was significantly higher (27% vs. 3%) in children receiving prophylactic antibiotics.
Conclusions:
- Hospitalized children with UTIs on prophylactic antibiotics are at increased risk for infections with third-generation cephalosporin-resistant organisms.
- Aminoglycoside antibiotics are a more appropriate treatment choice for these patients.
Background:
Children admitted to the hospital with urinary tract infections (UTIs) receive empirical antibiotic therapy. There is limited information on bacterial resistance to commonly prescribed intravenous antibiotics or on the risk factors for increased resistance in these patients.
Objectives:
To determine the antibiotic resistance pattern in children admitted to the hospital with UTIs, and to determine if history of UTI, antibiotic prophylaxis, or vesicoureteral reflux increases the risk of resistant organisms.
Design/Methods:
We reviewed all of the cases of UTI in children up to 18 years of age who were admitted during a 5-year period to Children's Hospital of Wisconsin, Milwaukee. We recorded age, sex, culture and sensitivity results, imaging that was performed, and past medical history.
Results:
We identified 361 patients with UTIs. Escherichia coli caused 87% of the infections, although E coli was significantly less common in children receiving prophylactic antibiotics (58%; P<.001) or in children with a history of UTI (74%; P<.001). Resistance to cefotaxime sodium was 3% in the patients not receiving antibiotic prophylaxis, but was 27% in the children receiving prophylactic antibiotics (relative risk, 9.9; 95% confidence interval, 4.0-24.5; P<.001). Resistance to aminoglycoside antibiotics was 1% in the children not receiving prophylaxis and 5% in the children receiving prophylactic antibiotics.
Conclusions:
Children who are receiving prophylactic antibiotics and are admitted to the hospital for a UTI are often infected with an organism that is resistant to third-generation cephalosporins. These children are more appropriately treated with an aminoglycoside antibiotic.
Related Concept Videos
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:25Mechanism of Antibiotic Resistance in MRSA
01:26Urinary Tract Infection I: Introduction
01:25Urinary Tract Infection II: Pathophysiology
01:28Acute Pyelonephritis II: Diagnostic Studies and Management