Increasing antibiotic resistance among uropathogens isolated during years 2006-2009: impact on the empirical...

Area of Science:

• Pediatric infectious diseases
• Antimicrobial resistance surveillance
• Clinical microbiology

Background:

• Urinary tract infections (UTI) are common in children, posing a challenge due to rising antimicrobial resistance.
• Empirical antibiotic selection for UTIs requires up-to-date local susceptibility data.
• This study analyzes trends in uropathogen resistance over time.

Purpose of the Study:

• To evaluate current antibiotic susceptibility patterns of uropathogens causing UTIs in children.
• To compare recent resistance data with previous findings to inform empirical treatment guidelines.
• To identify effective antibiotic options for various UTI severities in pediatric patients.

Main Methods:

• Retrospective analysis of bacterial isolates from pediatric UTIs between 2006-2009.
• Comparison of current data with a prior study conducted in 2002-2003.
• Assessment of antibiotic efficacy based on isolated uropathogen susceptibility.

Main Results:

• Escherichia coli (E. coli) was the predominant uropathogen, followed by Enterobacter and other gram-negative bacilli.
• Significant increases in resistance were observed for E. coli and gram-negative bacilli against common antibiotics like ceftriaxone, cefexime, and gentamicin.
• Imipenem, ciprofloxacin, and amikacin demonstrated high sensitivity rates (96.7%, 95%, 91% respectively).

Conclusions:

• Nitrofurantoin or nalidixic acid are appropriate for empirical treatment of cystitis.
• Amikacin or ceftriaxone followed by oral cephalosporins are suitable for febrile UTIs.
• Imipenem or a combination of ceftriaxone and an aminoglycoside are recommended for severe or complicated pediatric UTIs.