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Patterns of antibiotic resistance in uropathogens isolated from pediatric patients: A multicenter study
Zeyad A Almatroudi1, Abdullah M Almazrou1, Abdullah H Aljomoai1
1From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
Insights
Antibiotic resistance patterns in pediatric urinary tract infections (UTIs) vary by sex. Multidrug-resistant and ESBL-producing Escherichia coli are increasing, necessitating sex-specific surveillance for effective treatment strategies.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance surveillance
- Uropathogen analysis
Background:
- Urinary tract infections (UTIs) are common in children.
- Antibiotic resistance among uropathogens poses a significant public health challenge.
- Understanding resistance patterns is crucial for effective pediatric UTI management.
Purpose of the Study:
- To investigate antibiotic resistance patterns of common uropathogens in pediatric patients.
- To identify differences in resistance between male and female pediatric patients.
- To track trends in multidrug-resistant and ESBL-producing uropathogens.
Main Methods:
- Retrospective chart review of pediatric patients diagnosed with symptomatic, community-acquired UTIs.
- Data collected from tertiary and primary care centers in Riyadh, Saudi Arabia (2017-2022).
- Uropathogen identification and antibiotic susceptibility testing performed according to standard guidelines.
Main Results:
- 610 pediatric patients' data analyzed; 83.4% were female.
- Most common uropathogens: Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), Proteus mirabilis.
- E. coli was more prevalent in females (p<0.001). Multidrug-resistant E. coli was more frequent in males (39.2% vs 23.5%, p=0.014).
Conclusions:
- Antibiotic resistance surveillance for pediatric UTIs should be sex-specific.
- An increasing trend in multidrug-resistant and ESBL-producing E. coli isolates was observed.
- Sex-differentiated data is essential for guiding antimicrobial therapy in pediatric UTIs.
Objectives:
To evaluate the antibiotic resistance patterns in common uropathogens isolated from pediatric patients.
Methods:
This was a retrospective chart review on the uropathogens causing first-time, community-acquired, symptomatic urinary tract infection (UTI). The data for this study was collected from one tertiary care hospital and 4 primary care centers in Riyadh, Saudi Arabia, with data spanning from 2017-2022. Diagnosis of UTIs was in line with the guidelines of the American Academy of Pediatrics.
Results:
Isolates were gathered from 610 patients, 101 (16.6%) of whom were male and 509 (83.4%) were female. The 3 most common species isolated were Escherichia coli (E. coli; 50.5% in males and 82.7% in females), Klebsiella pneumoniae (K. pneumoniae; 28.7% males and 10.4% females), and then Proteus mirabilis (5.9% males and 2.9% in females). Escherichia coli was more prevalent in females than in males (p<0.001). Multidrugresistant E. coli was isolated more often from males than in females (39.2% versus 23.5%, p=0.014). A similar but non-significant trend was observed in multidrug-resistant K. pneumoniae (48.1% versus 30.8%, p=0.128), extended-spectrum beta-lactamase (ESBL) producing E. coli (13.7% versus 11.9%, p=0.701), and ESBL-producing K. pneumoniae (18.5% versus 7.7%, p=0.151).
Conclusion:
Our study indicates that surveillance of uropathogen resistance should differentiate between isolates gathered from male and female patients. This study also indicates a possible increase in ESBL-producing E. coli isolates, and an increase in multidrug-resistant E. coli isolates.
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