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Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children
Nader Shaikh1, Alejandro Hoberman1, Ron Keren2
1Division of General Academic Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
The Journal of Pediatrics
|January 23, 2016
Summary
Uncircumcised males, Hispanic children, and those with bladder bowel dysfunction or recent antibiotic use are more likely to have urinary tract infections resistant to narrow-spectrum antimicrobials.
Area of Science:
- Pediatrics
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Urinary tract infections (UTIs) are common in children.
- Identifying risk factors for antimicrobial resistance is crucial for effective treatment.
- Narrow-spectrum antimicrobials are often preferred for UTIs, but resistance is a growing concern.
Purpose of the Study:
- To identify demographic and clinical factors associated with resistance to narrow-spectrum antimicrobials in children with UTIs.
- To inform treatment guidelines and reduce the incidence of resistant UTIs in pediatric populations.
Main Methods:
- Analysis of data from 769 children (ages 2-71 months) from the Randomized Intervention for Children with Vesicoureteral Reflux and Careful Urinary Tract Infection Evaluation studies.
- Logistic regression models were used to assess associations between patient characteristics and antimicrobial resistance.
- Key factors examined included sex, circumcision status, presence of vesicoureteral reflux, bladder bowel dysfunction, and recent antibiotic exposure.
Main Results:
- Uncircumcised males had approximately 3 times the risk of resistance compared to females (OR 3.1).
- Children with bladder bowel dysfunction showed 2 times the risk of resistance (OR 2.2).
- Recent antibiotic use (1 course in 6 months) increased the odds of resistance (OR 1.6), as did Hispanic ethnicity.
Conclusions:
- Uncircumcised males, Hispanic children, and those with bladder bowel dysfunction are at higher risk for UTIs caused by resistant pathogens.
- Children who received recent antibiotic therapy are also more likely to harbor resistant organisms.
- These findings highlight specific pediatric groups requiring careful consideration for antimicrobial selection in UTI management.
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