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General Characteristics and Current State of Antibiotic Resistance in Pediatric Urinary Tract Infection-A Single
Raluca Isac1,2, Gabriela Doros1,2, Cristiana-Alexandra Stolojanu3
1Department of Pediatrics, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Insights
Pediatric urinary tract infections (UTIs) show rising antibiotic resistance, particularly in girls and those with congenital anomalies. Updated treatment guidelines are crucial for effective management of pediatric UTIs.
Area of Science:
- Pediatric infectious diseases
- Clinical microbiology
- Antibiotic resistance
Background:
- Urinary tract infections (UTIs) are common bacterial infections in children, frequently caused by Gram-negative bacteria.
- Empirical antibiotic treatment relies on guidelines and local resistance data.
- Understanding current UTI characteristics in children is essential for effective treatment.
Purpose of the Study:
- To provide a clear overview of current pediatric urinary tract infection (UTI) particularities.
- To analyze pathogen prevalence and antibiotic resistance patterns in pediatric UTIs.
Main Methods:
- Analysis of 210 positive urine cultures from 141 pediatric patients over six months.
- Evaluation of patient demographics, origin, and presence of Congenital Anomalies of the Kidney and Urinary Tract (CAKUT).
Main Results:
- Most patients were female (57%), with a median age of 5 years. Escherichia coli was the most frequent pathogen.
- Increased resistance observed for Ampicillin and Trimethoprim/Sulfamethoxazole, especially in patients with CAKUT.
- Effective antibiotics for Gram-negative UTIs include aminoglycosides, Meropenem, third-generation Cephalosporins, and Nitrofurantoin; Vancomycin for Gram-positive UTIs.
Conclusions:
- Periodic analysis is necessary to update clinicians on uropathogen antibiotic resistance.
- Optimal empirical treatment strategies for pediatric UTIs require constant re-evaluation based on resistance data.
Abstract:
Urinary tract infection (UTI) represents one of the most common bacterial infections in children, mainly caused by Gram-negative bacteria. Empirical antibiotic treatment is based on international and national guidelines for treating UTIs in children and is individualized with local antibiotic resistance patterns. The aim of this study is to bring a clear view of present-day particularities of UTIs in children.
Methods:
We analyzed 210 positive urine cultures identified in 141 pediatric patients admitted to the hospital over a 6-month period.
Results:
The majority of patients were females (57%) with a median age of 5 years (IQR 12), while male patients revealed a median age of 2 (IQR 7). Most patients originated from urban areas (53%). Only 18 patients (12.76%) were identified with underlying Congenital Anomalies of the Kidney and Urinary Tract (CAKUT). Escherichia Coli was the most frequent pathogen. Increased antibiotic resistance was found in commonly-used antibiotics Ampicillin and Trimethoprim/Sulfamethoxazole, and in the case of patients with CAKUT. Suitable antibiotics for treating a Gram-negative UTI are aminoglycosides, Meropenem, third-generation Cephalosporins, and Nitrofurantoin. Vancomycin upholds efficacy in treating a Gram-positive pediatric UTI.
Conclusion:
Periodical analysis needs to be performed in order to constantly update clinicians on uropathogenic antibiotic resistance and optimal empirical treatment options.
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