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Antibiotic sensitivity and resistance in children with urinary tract infection in Sanliurfa
Mahmut Abuhandan1, Bülent Güzel1, Yeşim Oymak1
1Department of Pediatrics, Faculty of Medicine, Harran University, Şanlıurfa, Turkey.
Insights
Antibiotic resistance in pediatric urinary tract infections (UTIs) varies by pathogen and drug. Escherichia coli showed high resistance to common antibiotics, while imipenem and aminoglycosides remained effective. Treatment guidelines should be updated based on regional resistance patterns.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Clinical pharmacology
Background:
- Urinary tract infections (UTIs) are common in children.
- Antibiotic resistance poses a significant challenge to effective UTI treatment.
- Regional variations in antibiotic resistance necessitate localized treatment strategies.
Purpose of the Study:
- To evaluate antibiotic resistance patterns in pediatric UTIs in Şanliurfa, Turkey.
- To identify prevalent uropathogens and their susceptibility profiles.
- To inform empirical antibiotic treatment guidelines for pediatric UTIs in the region.
Main Methods:
- A retrospective analysis of 107 children diagnosed with UTIs.
- Urine culture and bacterial growth analysis.
- Assessment of pathogen frequency and antibiotic sensitivity testing.
Main Results:
- Escherichia coli was the most common pathogen (64.5%), exhibiting high resistance to ceftriaxone, nitrofurantoin, ampicillin-sulbactam, co-trimoxazole, amoxicillin-clavulanate, and cefuroxime.
- All tested microorganisms showed resistance to ampicillin-sulbactam, amoxicillin-clavulanate, co-trimoxazole, ceftriaxone, cefuroxime, and cefoxitin.
- Imipenem, sulperazone, quinolones, and aminoglycosides were the most effective agents.
Conclusions:
- Aminoglycosides and 3rd generation cephalosporins are recommended for empirical parenteral UTI treatment in all age groups in this region.
- Co-trimoxazole may be suitable for infants aged 0-1, and 2nd generation cephalosporins for oral treatment in children aged 1-5.
- Low nitrofurantoin resistance in children over 5 suggests its potential utility for oral therapy in this age group.
Objective:
This study aimed to evaluate antibiotic resistance in the province of Şanliurfa and to observe any difference between antibiotic resistance rates.
Material And Methods:
The study comprised 107 children who presented at the pediatric polyclinic with complaints of urinary tract infection with the diagnosis of urinary tract infection and whose urine cultures exhibited bacterial growth. The patients were analyzed with respect to the frequency of proliferating pathogens, sensitivity to the antibiotics used and the rates of developed resistance to the antibiotics.
Results:
A total of 107 patients aged between 1 year and 15 years were included in the study, encompassing 14 (13.1%) males and 93 (86.9%) females. According to the urine culture results, proliferation of Escherichia coli (E. coli) was observed in 69 (64.5%), Klebsiella spp. in 13 (12.1%), Proteus mirabilis in 9 (8.4%), Staphylococcus aureus in 5 (4.7%), Pseudomonas aeruginosa in 5 (4.7%), Acinetobacter spp. in 3 (2.8%) and Enterococcus spp. in 3 (2.8%) patients. For proliferating E. coli, high resistance rates to ceftriaxone (39.5%), nitrofurantoin (19.7%), ampicillin-sulbactam (64.1%), co-trimoxazole (41.5%), amoxicillinclavulanate (51.7%) and cefuroxime (38.1%) were observed. All of isolated microorganisms were resistant to ampicillin-sulbactam, amoxicillin-clavulanate, co-trimoxazole, ceftriaxone, cefuroxime and cefoxitin in decreasing frequencies. The most effective antimicrobial agents were determined to be imipenem, sulpera-zone, quinolone and aminoglycosides.
Conclusion:
In our region, parenteral antibiotics that should be selected for the empirical treatment of UTIs in all age groups are the aminoglycosides and 3(rd) generation cephalosporines. In contrast to other studies, these results suggest that co-trimoxazole should be used for children aged 0-1, and 2(nd) generation cephalosporins should be used for the oral treatment of children aged 1-5 due to the low rate of resistance to nitrofurantoin in patients aged over 5 years.