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Antibiotic Resistance and Bacteria in Urinary Tract Infections in Pediatric Patients
Yakup Cag1, Demet Haciseyitoglu2, Abdurrahman Avar Ozdemir3
1University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Department of Pediatrics, Istanbul, Turkey.
Insights
Antibiotic resistance in pediatric urinary tract infections (UTIs) is a growing concern. This study identified common UTI pathogens in children and their resistance patterns, highlighting the need for localized antibiotic susceptibility data to guide treatment.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Antimicrobial resistance
Background:
- Antibiotic resistance in bacterial pathogens causing urinary tract infections (UTIs) is a significant global health issue.
- Understanding the specific causative agents and their resistance profiles in pediatric populations is crucial for effective treatment.
Purpose of the Study:
- To determine the microorganisms responsible for UTIs in children under 17 years old at a specific hospital.
- To assess the antibiotic resistance rates of these identified pathogens.
Main Methods:
- Retrospective analysis of 4801 urine samples from children under 17 with confirmed bacterial growth.
- Statistical analysis of isolated bacteria and their corresponding antibiotic resistance profiles.
Main Results:
- Escherichia coli was the most common pathogen (67.7%), followed by Klebsiella spp. (10.7%) and Enterococcus spp. (8.8%).
- Ampicillin showed high resistance rates (66.6%) against E. coli, while meropenem exhibited low resistance (0.3%).
- Enterococcus faecium demonstrated significantly higher resistance to ampicillin and ciprofloxacin compared to Enterococcus faecalis.
Conclusions:
- Local antibiograms are essential for guiding empirical antibiotic therapy in pediatric UTIs.
- Regularly reassessing antibiotic susceptibility and adjusting empirical treatments based on culture results can help mitigate resistance rates.
Objective:
Antibiotic resistance against bacterial pathogens associated with urinary tract infections (UTI) is rapidly increasing worldwide. In this study, we aimed at determining the causative microorganisms in children under 17 years of age diagnosed with UTI in our hospital and the antibiotic resistance rates of these causes.
Methods:
We isolated and retrospectively analyzed 4801 urine samples of children under 17 years old who presented with bacterial growth in their urine cultures. The isolated bacteria and their antibiotic resistance profiles were statistically analyzed.
Results:
Most (2001/77.2%) of 2592 patients included in the study were female and the mean age and median interquartile range (IQR) was 55 (12-98) months. Except for the neonatal period, the female gender was predominant in all age groups (p<0.0001). The most frequently isolated bacteria included Escherichia coli (67.7%), Klebsiella spp. (10.7%), and Enterococcus spp. (8.8%). The most and least resistant antibiotics were ampicillin (66.6%) and meropenem (0.3%) for E. coli, respectively. Although resistance of E. faecalis to ampicillin and ciprofloxacin is at a low level, E. faecium is much more resistant to these antibiotics (p<0.0001).
Conclusion:
It is important that each center determines its own resistant antibiotics so as to guide empirical treatment. Re-evaluating each antibiotic that is started to be used empirically according to the results of culture and sensitivity in addition to switching to a suitable antibiotic would be very effective in reducing resistance rates.
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