Pathogens Causing Pediatric Community Acquired Urinary Tract Infections and Their Increasing Antimicrobial...

Area of Science:

• Pediatric infectious diseases
• Antimicrobial resistance
• Urology

Background:

• Urinary tract infections (UTIs) are common in children, causing significant morbidity and potential long-term complications.
• Optimizing empiric antibiotic therapy for pediatric UTIs requires up-to-date data on causative pathogens and their resistance patterns.

Purpose of the Study:

• To investigate pathogens causing community-acquired UTIs in children.
• To analyze correlations between uropathogens and demographic characteristics.
• To identify trends in antimicrobial resistance of pediatric UTI pathogens over time.

Main Methods:

• Nationwide cross-sectional study involving 53,203 children (<18 years) diagnosed with UTI.
• Data collected from community outpatient clinics in selected years: 2007, 2011, 2015, 2019, and 2021.
• Analysis of pathogen distribution, demographic correlations, and antimicrobial resistance trends.

Main Results:

• Escherichia coli (E. coli) was the most frequent uropathogen (82.1%), followed by Enterobacter, Klebsiella, Proteus, Pseudomonas, and Enterococcus species.
• Significant gender- and sector-specific patterns were observed, with higher non-E. coli UTI prevalence in Jewish males.
• The rate of extended-spectrum beta-lactamase (ESBL)-positive E. coli significantly increased from 6.1% in 2007 to 25.4% in 2021.

Conclusions:

• E. coli is the predominant pathogen in pediatric community-acquired UTIs, but resistance patterns are evolving.
• Increasing ESBL-producing E. coli and resistance in non-E. coli uropathogens necessitate careful selection of empiric antibiotics.
• Periodic, local assessment of antimicrobial resistance is crucial for updating treatment guidelines and ensuring effective therapy for pediatric UTIs.