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Urinary Tract Infections in Children - Microbiological Challenges and Mechanisms of Bacterial Resistance
Andrei-Dan Marinescu1,2, Maria-Cristina Marinescu1, Stefana-Maria Moisa3,4
1"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Insights
Urinary tract infections (UTIs) in children are common and can lead to serious complications. This review details the antibiotic resistance mechanisms in bacteria causing pediatric UTIs, crucial for effective treatment.
Area of Science:
- Pediatric infectious diseases
- Microbial resistance mechanisms
- Urology
Background:
- Urinary tract infections (UTIs) are prevalent in children, with millions of cases annually.
- While treatable with antibiotics, UTIs risk sepsis, kidney issues, and antibiotic resistance.
- Symptoms in children range from non-specific (fever) to specific (dysuria, pain).
Purpose of the Study:
- To review the mechanisms of antibiotic resistance in bacteria causing UTIs in children.
- To highlight common resistance strategies employed by UTI-causing pathogens.
- To inform clinical understanding and management of pediatric UTIs.
Main Methods:
- Literature review of studies on pediatric UTIs and bacterial resistance.
- Analysis of common resistance mechanisms, including beta-lactamase production.
- Examination of resistance to antibiotics like polymyxins, methicillin, and vancomycin.
Main Results:
- Key resistance mechanisms include beta-lactamase production, polymyxin resistance in Gram-negatives.
- Specific pathogens like Staphylococcus aureus exhibit methicillin resistance.
- Enterococcus spp. and S. aureus can develop vancomycin resistance.
Conclusions:
- Understanding these resistance mechanisms is vital for treating pediatric UTIs.
- Antibiotic resistance poses a significant challenge in managing pediatric urinary tract infections.
- Further research into resistance patterns can guide therapeutic strategies.
Abstract:
Urinary tract infections (UTIs) are common both in adults and particularly in children. It is estimated that the number of UTI cases has reached 4.49 billions in 2021, while common and often successfully treated with antibiotics UTIs pose the risk for sepsis, kidney complications and occurrence of antibiotic-resistant microbial strains. Symptoms of UTIs in children vary from non-specific, such as fever and lethargy, to specific such as difficult voiding, dysuria and suprapubic, abdominal or lumbar pain. Urinary tract infections may be lower (cystitis) or upper (pyelonephritis) and the etiological diagnosis is based on urinalysis and urine culture. There are several resistance mechanisms that commonly occur across different bacterial species (some of them being found in the same family) responsible for pediatric UTIs. For instance, an extensive mechanism of resistance is the production of beta-lactamase. Gram-negative bacilli may also develop polymyxin resistance; Staphylococcus aureus may become methicillin resistant and vancomycin resistance may appear in both S. aureus and Enterococcus spp. The present review presents the mechanisms of resistance of bacteria involved in UTIs in children.
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