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Sociodemographic and Clinical Correlates of Multidrug-Resistant Uropathogens in Hospitalized Children

Khitam Muhsen1, Sama Haleem1, Bshara Mansour2,3

  • 1Department of Epidemiology and Preventive Medicine, School of Public Health, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

Infection and Drug Resistance
|April 14, 2026
PubMed

Insights

Multidrug-resistant (MDR) Gram-negative bacteria are a growing concern in pediatric urinary tract infections (UTIs). Prior antibiotic use and Arab ethnicity are risk factors for MDR, highlighting the need for targeted interventions.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Microbiology
  • Antimicrobial Resistance

Background:

  • Antibiotic resistance in uropathogens is a significant global health challenge.
  • Urinary tract infections (UTIs) are common in children, with increasing rates of resistance.
  • Data on multidrug-resistant (MDR) Gram-negative bacteria in pediatric UTIs are limited.

Purpose of the Study:

  • To determine the prevalence and risk factors of Gram-negative MDR bacteria in pediatric UTIs.
  • To compare hospitalization duration and costs between children with and without MDR infections.
  • To inform empirical therapy and antibiotic stewardship strategies.

Main Methods:

  • Retrospective single-center study of hospitalized children (2015-2020).
  • Data collected included sociodemographic, clinical, and laboratory parameters.
  • MDR defined as non-susceptibility to ≥1 agent in ≥3 antimicrobial classes.

Main Results:

  • The study included 506 children; 94.2% of isolates were Gram-negative.
  • MDR prevalence was 6.9%; 50.8% showed resistance/intermediate susceptibility to 1-2 antibiotic categories.
  • Risk factors for MDR included Arab ethnicity (OR=3.29) and prior antibiotic use (OR=5.06).
  • Hospitalization duration and cost did not differ significantly between MDR and non-MDR groups.

Conclusions:

  • The prevalence of MDR and resistance to multiple antibiotic categories in Gram-negative uropathogens is concerning.
  • Prior antibiotic use and ethnicity are significant risk factors for MDR in pediatric UTIs.
  • Findings emphasize the need for tailored empirical antibiotic therapy and robust stewardship programs.
Abstract

Keywords:
antibiotic resistancechildrenmultidrug resistanceurinary tract infectionuropathogens

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