General Characteristics and Current State of Antibiotic Resistance in Pediatric Urinary Tract Infection-A Single Center Experience

• Published in: Antibiotics (Basel) Vol. 13; no. 8; p. 684
• Main Authors: Isac, Raluca, Doros, Gabriela, Stolojanu, Cristiana-Alexandra, Steflea, Ruxandra Maria, Stroescu, Ramona Florina, Olariu, Ioana-Cristina, Micsescu-Olah, Andrada-Mara, Gafencu, Mihai
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24-07-2024; MDPI
• Subjects: Age; Aminoglycosides; Ampicillin; Antibiotic resistance; Antibiotics; Bacteria; Bacterial diseases; Bacterial infections; Care and treatment; Causes of; Cephalosporins; Chi-square test; Children; Congenital anomalies; Congenital defects; Demographic aspects; Diagnosis; Drug resistance; Drug resistance in microorganisms; E coli; Females; Gender; Gram-negative bacteria; Gram-positive bacteria; kidney anomalies; Males; Meropenem; Nitrofurantoin; Pathogens; Patients; Pediatrics; Risk factors; Sulfamethoxazole; Trimethoprim; Urban areas; Urinary tract; Urinary tract diseases; urinary tract infection; Urinary tract infections; Urine; Urogenital system; Vancomycin; Romania; kidney anomalies; antibiotic resistance; children; urinary tract infection
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics13080684

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.
We analyzed 210 positive urine cultures identified in 141 pediatric patients admitted to the hospital over a 6-month period.
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.
Periodical analysis needs to be performed in order to constantly update clinicians on uropathogenic antibiotic resistance and optimal empirical treatment options.