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Community-acquired urinary tract infections in children: pathogens, antibiotic susceptibility and seasonal changes
1Department of Pediatrics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. ilyasyolbas@hotmail.com
Insights
Community-acquired urinary tract infections (UTIs) in children are often caused by Escherichia coli and Klebsiella. High antibiotic resistance necessitates careful antibiotic selection for effective treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Urinary tract infections (UTIs) are prevalent in pediatric populations.
- Understanding causative agents and their antibiotic susceptibility is crucial for effective management.
Purpose of the Study:
- To identify the microorganisms responsible for community-acquired UTIs in children.
- To assess the antibiotic susceptibility patterns of these pathogens.
Main Methods:
- A retrospective study of 150 children with positive urine cultures.
- Data collected from Pediatric Polyclinics between June 2010 and June 2011.
Main Results:
- Escherichia coli (75.3%) and Klebsiella (20.7%) were the most common pathogens.
- Significant antibiotic resistance was observed, particularly against trimethoprim/sulfamethoxazole and amoxicillin/clavulanate for E. coli.
Conclusions:
- Increasing antibiotic resistance in community-acquired UTIs is a concern in developing countries like Turkey.
- Empirical antibiotic treatment should consider local resistance patterns, with nitrofurantoin and cefoxitin suggested as potentially effective options.
Aim:
Urinary tract infections (UTIs) are common infections affecting children. The aim of our study is to determine microorganisms that cause community-acquired urinary tract infections and their antibiotic susceptibility in children.
Materials And Methods:
Our investigation includes 150 cases which has positive urine culture. The cases are detected at Pediatric Polyclinics of Dicle University between June 2010 and June 2011.
Results:
The study included 118 (78.7%) female and 32 (21.3%) male children. Urinary tract infections were seen in autumn 10.7% (n = 16), summer 35.3% (n = 53), winter 30.7% (n = 46) and spring 23.3% (n = 35). The culture results indicated 75.3% (n = 113) Escherichia coli; 20.7% (n = 31) Klebsiella; 2.7% (n = 4) Proteus and % 1.3 (n = 2) Pseudomonas. The antibiotic resistance against Escherichia coli was found out is amikacin (3%), ertapenem (7%), imipenem (0%), meropenem (0%), nitrofurantoin (9%), trimethoprim/sulfamethoxazole (58%), piperacillin (83%), amoxicillin/clavulanate (50%), ampicillin/sulbactam (65%), cefazolin (54%), cefotaxime (51%), cefuroxime sodium (51% ) and tetracycline (68%). The resistance ratios of Klebsiella are amikacin (0%), imipenem (0%), levofloxacin (0%), meropenem (0%), amoxicillin/clavulanate (57%), ampicillin/sulbactam (79%), ceftriaxone (68%), cefuroxime sodium (74%) and trimethoprim/sulfamethoxazole (61%).
Conclusions:
The results represent the increasing antibiotic resistance against microorganisms among the community-acquired UTI patients in a developing country such as Turkey. So, the physicians should consider resistance status of the infectious agent and choose effective antibiotics which are nitrofurantoin and cefoxitin for their empirical antibiotic treatment. Furthermore, they should be trained about selection of more effective antibiotics and check the regional studies regularly.
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