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Updated: Feb 12, 2026

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Published on: August 5, 2010
Antibiotic resistance patterns of urinary tract pathogens in Turkish children
Suzan Gunduz1, Hatice Uludağ Altun2
1Department of Pediatrics, Private Batman Hospital, Gultepe mah. Palmiyem 1 sitesi D blok no: 13, Batman, Turkey.
Insights
This study found Escherichia coli to be the most common cause of pediatric urinary tract infections. High resistance to ampicillin and co-trimoxazole necessitates careful antibiotic selection for effective treatment.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Resistance Surveillance
- Clinical Microbiology
Background:
- Understanding local antimicrobial resistance (AMR) patterns is crucial for effective empirical antibiotic prescribing in pediatric urinary tract infections (UTIs).
- This study investigated the changing landscape of UTI pathogens and their resistance profiles in children within a specific healthcare setting.
Purpose of the Study:
- To determine the primary causative agents of UTIs in children.
- To analyze the antimicrobial resistance patterns of these pathogens.
- To recommend optimal antibiotic choices for empirical treatment of pediatric UTIs.
Main Methods:
- A retrospective analysis of urine isolates from positive cultures in children was conducted.
- Data were collected from September 2014 to April 2016 at a single hospital in Ankara, Turkey.
- Causative agents and their corresponding antimicrobial susceptibility were identified.
Main Results:
- A total of 850 pediatric urine cultures were analyzed, with Escherichia coli (64.2%) being the predominant pathogen, followed by Klebsiella pneumoniae (14.9%).
- Significant resistance was observed for ampicillin (62.6%), cephalothin (44.2%), co-trimoxazole (29.8%), and cefuroxime (28.7%).
- Imipenem showed no resistance, while amikacin, ceftriaxone, ciprofloxacin, and cefepime exhibited low resistance rates.
Conclusions:
- Escherichia coli is the leading cause of UTIs in the pediatric population studied.
- High resistance rates to ampicillin, trimethoprim-sulfamethoxazole, cephalothin, and cefuroxime were noted.
- Cefixime is suggested as a suitable oral empirical antibiotic choice, considering its activity against common pathogens including Klebsiella species.
Background:
Knowledge of local antimicrobial resistance patterns is essential for evidence- based empirical antibiotic prescribing. We aimed to investigate the distribution and changes in causative agents of urinary tract infections in children and the resistance rates, and to recommend the most appropriate antibiotics.
Methods:
In this retrospective study, we evaluated causative agents and antimicrobial resistance in urine isolates from the positive community from September 2014 to April 2016 in a single hospital in Ankara, Turkey.
Results:
A total of 850 positive urine cultures were identified, of which 588 (69.2%) were from girls and 262 (30.8%) were from boys. Their mean age was 36.5 ± 45.0 months. The most common causative agent was Escherichia coli (64.2% of cases) followed by Klebsiella pneumoniae (14.9%). The overall resistance to ampicillin (62.6%), cephalothin (44.2%), co-trimoxazole (29.8%) and cefuroxime (28.7%) was significant. No resistance to imipenem was detected in the isolates. The least resistance was for amikacin, ceftriaxone, ciprofloxacin and cefepime (0.1, 2.4, 7.5 and 8.3%, respectively). Imipenem was the most active agent against E. coli followed by amikacin (0.2%), ceftriaxone (2.7%) and nitrofurantoin (5.1%). High resistance rates to nitrofurantoin were detected in K. pneumoniae, Proteus and Enterobacteriae.
Conclusions:
E. coli was the most common causative agent of urinary tract infection in children. Ampicillin, trimethoprim-sulfometaxazole, cephalothin and cefuroxim had the highest resistance rates against urinary tract pathogens in our center. For oral empirical antibiotherapy, cefixime is the most appropriate choice so as to include Klebsiella strains.
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