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Causative pathogens and antibiotic resistance in children hospitalized for urinary tract infection
Mesut Koçak1, Bahar Büyükkaragöz2, Asli Çelebi Tayfur2
1Department of Pediatrics, Keçiören Training and Research Hospital, Ankara, Turkey.
Insights
Pediatric urinary tract infections (UTIs) show increasing resistance to antibiotics, particularly from extended-spectrum beta-lactamase (ESBL) producing bacteria. This highlights the need for judicious antibiotic use in hospitalized children.
Area of Science:
- Pediatric infectious diseases
- Clinical microbiology
- Antibiotic resistance
Background:
- Urinary tract infections (UTIs) are a common cause of hospitalization in children.
- Understanding causative pathogens and resistance patterns is crucial for effective treatment.
Purpose of the Study:
- To investigate clinical characteristics, uropathogens, antibiotic susceptibility, and treatment outcomes in hospitalized pediatric UTIs.
- To identify trends in antibiotic resistance, including extended-spectrum beta-lactamase (ESBL) production.
Main Methods:
- Retrospective analysis of 142 children hospitalized with upper UTIs (March 2009 - July 2014).
- Recorded urine culture-antibiogram results and urinary tract abnormalities.
- Analyzed demographic data, medical history, and treatment efficacy.
Main Results:
- Escherichia coli was the most common pathogen (80.3%).
- Extended-spectrum beta-lactamase (ESBL)-producing strains were found in 49.3% of cases.
- All ESBL-producing strains exhibited third-generation cephalosporin resistance, correlating with longer hospital stays.
Conclusions:
- A rising prevalence of multi-drug resistant, ESBL-producing bacteria in pediatric UTIs is observed.
- Rational antibiotic stewardship is essential to combat increasing antimicrobial resistance in hospitalized children.
Background:
Urinary tract infections (UTI) are one of the most common bacterial infections in children and a major cause of hospitalization. In this study we investigated the clinical characteristics, causative uropathogens; their antibiotic susceptibility and resistance patterns, treatment modalities and efficacy in children hospitalized for UTI in a tertiary care setting.
Methods:
Patients hospitalized for an upper UTI between March 2009 and July 2014 were enrolled. The urine culture-antibiogram results and accompanying urinary tract abnormalities were recorded retrospectively.
Results:
A total of 142 patients (104 girls, 73.2%; 38 boys, 26.8%) were enrolled. Mean patient age was 32.6 ± 4.1 months. History of recurrent UTI was present in 45.8% (n = 65), with prior hospitalization in 12.0% (n = 17). Frequency of vesicoureteral reflux was 18.3% (n = 26). Gram-negative enteric microorganisms yielded growth in all culture-positive UTI and the most common microorganism was Escherichia coli (n = 114, 80.3%). Extended spectrum beta-lactamase-producing (ESBL (+)) bacterial strains were detected in 49.3% (n = 70), with third-generation cephalosporin resistance in all and increased duration of hospitalization.
Conclusions:
The prevalence of UTI with ESBL (+) bacterial strains with multi-drug resistance is increasing in the hospitalized pediatric population, therefore rational use of antibiotics is essential.
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