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Bacterial Pathogens and Antimicrobial Susceptibility Patterns of Urinary Tract Infections in Children during COVID-19
Ibraheem Altamimi1, Abeer Almazyed2, Sami Alshammary3
1College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia.
Insights
Pediatric urinary tract infections (UTIs) in Saudi Arabia show high resistance to common antibiotics. Meropenem, ertapenem, and amikacin are effective treatments for common UTI pathogens, including ESBL-producers.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Antimicrobial Resistance
Background:
- Urinary tract infections (UTIs) are common in children, posing a significant health challenge due to increasing antimicrobial resistance.
- This study addresses the growing concern of pathogen resistance to standard antimicrobial agents in pediatric UTIs.
Purpose of the Study:
- To determine the antimicrobial susceptibility patterns of pathogens causing UTIs in children in Saudi Arabia.
- To identify the prevalence and resistance patterns of extended-spectrum beta-lactamase (ESBL)-producing bacteria in pediatric UTIs.
Main Methods:
- A cross-sectional retrospective study analyzed 1022 urine samples from children (0-15 years) with UTIs from 2019-2020.
- Uropathogens were identified using standard biochemical techniques, and antimicrobial susceptibility was assessed via in vitro methods following CLSI guidelines.
- Extended-spectrum beta-lactamase (ESBL) production in E. coli was identified using a double-disc synergy test.
Main Results:
- Escherichia coli (58.6%) and Klebsiella sp. (23.9%) were the predominant uropathogens.
- E. coli showed high sensitivity to meropenem, ertapenem (99.2%), and amikacin (99%). Klebsiella sp. were sensitive to amikacin (97.1%) and meropenem/ertapenem (92.2%).
- Extended-spectrum beta-lactamase (ESBL) isolates demonstrated highest sensitivities to meropenem and ertapenem (100%), followed by amikacin (99%).
Conclusions:
- Local antibiotic sensitivity data are recommended for empirical treatment of pediatric UTIs.
- Amikacin, ertapenem, and meropenem are effective intravenous treatment options.
- Cephalosporins, cefuroxime, amoxicillin/clavulanic acid, and nitrofurantoin are suggested oral choices; no significant pandemic-related changes in susceptibility were observed.
Background:
One of the most prevalent bacterial infections in children is urinary tract infection (UTI), which has become a major concern with increasing resistance of the pathogens to the routinely used antimicrobial agents. The aim of the study is to determine the antimicrobial susceptibility patterns of pediatric UTI-causing pathogens, including ESBL-producing bacteria, in Saudi Arabia.
Methods:
This cross-sectional retrospective study was conducted to ascertain the frequency of isolation and the antimicrobial resistance pattern of uropathogens among children aged 0-15 years. The data from the urine cultures was collected during 2019-2020 at the King Fahad Medical City, a major tertiary hospital in Riyadh, Saudi Arabia. A total of 1022 urine samples from patients diagnosed with urinary tract infections (UTIs) were collected for this study. Microbial species present in the samples were cultured and identified using standard biochemical techniques. To assess the resistance of these strains to antimicrobial drugs, an in vitro method was employed, and the criteria set by the Clinical Laboratory Standard Institute (CLSI) were followed. In addition, a double-disc synergy test was conducted to identify strains of E. coli that produce extended-spectrum beta-lactamase (ESBL).
Results:
The predominant pathogens were E. coli (58.6%), followed by Klebsiella sp. (23.9%). E. coli isolates were more sensitive to meropenem and ertapenem in 99.2% of cases, followed by amikacin (99%). Klebsiella sp. were sensitive to amikacin in 97.1% of cases, followed by meropenem and ertapenem (92.2% in both). The highest sensitivities of antimicrobials toward ESBL were for meropenem and ertapenem (100% in both), followed by amikacin (99%).
Conclusions:
Our study recommends using local antibiotic sensitivity data for empirical UTI treatment. Amikacin, ertapenem, and meropenem are effective intravenous options. Cephalosporin, cefuroxime, amoxicillin/clavulanic acid, and nitrofurantoin are suitable oral choices. No significant changes in antimicrobial susceptibility were observed during the COVID-19 pandemic. Further research is needed to assess potential pandemic-related alterations.
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