Antibiotic resistance in childhood urinary tract infections: A single-center experience

Area of Science:

• Pediatric infectious diseases
• Clinical microbiology
• Antimicrobial resistance

Background:

• Urinary tract infections (UTIs) are prevalent in children, with inappropriate antibiotic use escalating resistance.
• Understanding pathogen prevalence and resistance patterns is crucial for effective UTI management in pediatric populations.

Purpose of the Study:

• To determine the prevalence of UTI pathogens in pediatric patients.
• To analyze antibiotic resistance patterns.
• To inform empirical treatment strategies for childhood UTIs.

Main Methods:

• Retrospective analysis of urine culture and antibiogram data from pediatric patients (0-16 years) between 2013-2017.
• Antibiotic susceptibility testing performed using the disc diffusion method (Clinical and Laboratory Standards Institute guidelines).

Main Results:

• Escherichia coli (E. coli) was the predominant pathogen, identified in 85.8% of positive cultures.
• High resistance rates were observed for ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, cefuroxime axetil, and trimethoprim-sulfamethoxazole (TMP-SMX).
• Low resistance was noted for amikacin, meropenem, imipenem, ertapenem, fosfomycin, and nitrofurantoin.

Conclusions:

• E. coli is the primary causative agent of UTIs in the pediatric population studied.
• Significant resistance to several commonly prescribed antibiotics necessitates updated empirical treatment guidelines for pediatric UTIs.
• Favorable susceptibility profiles for amikacin, carbapenems, fosfomycin, and nitrofurantoin suggest their potential utility.