Microbial sensitivity pattern in urinary tract infections in children: a single center experience of 1,177 urine
Mostafa Sharifian1, Abdollah Karimi, Sedigheh Rafiee Tabatabaei
1Pediatric Infectious Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. msharif@sbmu.ac.ir
Insights
Urinary tract infections are common in children. This study found significant geographic variations in antibiotic resistance, emphasizing the need for localized treatment strategies for pediatric urinary pathogens.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Urinary tract infections (UTIs) are a frequent pediatric illness, with prompt diagnosis and treatment crucial for preventing severe complications.
- Understanding local antimicrobial susceptibility patterns is vital for effective empirical antibiotic selection in pediatric UTIs.
Purpose of the Study:
- To assess the antibiotic resistance patterns of common urinary pathogens in children treated at Mofid Children's Hospital.
- To provide data that can inform antibiotic prescribing practices for pediatric UTIs in the region.
Main Methods:
- Analysis of positive urine cultures from 1,177 children under 12 years old between March 2000 and August 2001.
- Urine sample collection methods varied by age (sterile bags for infants, midstream for older children, suprapubic aspiration if contaminated).
- Antimicrobial sensitivity testing was performed using the disc diffusion method following NCCLS guidelines.
Main Results:
- Escherichia coli was the most frequent pathogen, identified in 56.6% of cases.
- The lowest observed resistance rate was to ciprofloxacin (6.7%), while the highest was to penicillin (83%).
- Significant geographic variations in pathogen resistance patterns were noted compared to international data.
Conclusions:
- Antibiotic resistance patterns for pediatric urinary pathogens exhibit considerable geographic variability.
- Empirical antibiotic therapy for pediatric UTIs should be guided by local antimicrobial susceptibility data.
- This study highlights the importance of regional surveillance for optimizing UTI treatment in children.
Abstract:
Urinary tract infection is one of the most common diseases in children. Early diagnosis and comprehensive treatment can significantly decrease late serious complications. Knowledge of the sensitivity and resistance pattern of uropathogens in specific geographical locations is an important factor for choosing suitable antibacterial treatment. This study was conducted in order to evaluate the antibacterial resistance of urinary pathogens at Mofid Children's Hospital between March 2000 and August 2001. Positive urine cultures from 1,177 children aged less than 12 years (mean age, 31.7 months; female to male ratio, 2:1) were studied. Cultures were performed on urine samples obtained by sterile urine bags in infants and midstream urine in older children; if samples were contaminated then a suprapubic sample was taken in infants. Sensitivity was measured by the disc diffusion method using the NCCLS protocol. The most prevalent urinary pathogen was Escherichia coli (666 cases, 56.6%). Overall, the lowest resistance rate of microorganisms was that against ciprofloxacin (6.7%) and the highest resistance rate was that against penicillin (83%). A comparison of these data with those of other countries shows that there is considerable geographic variation in bacterial patterns of sensitivity and resistance properties. Therefore, the selection of antibiotics for empiric therapy should be based on the sensitivity and resistance pattern of uropathogens in the respective city.
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