Urinary Tract Infections in Children: Clinical and Antibiotic Susceptibility Data from a Tertiary Care Hospital

Abstract

Aim: Urinary tract infections (UTIs) are among the most common bacterial infections in children. Empirical antibiotic treatment is recommended until the antibiogram reports of urine culture are available. It is essential to initiate local UTI agents and their antimicrobial susceptibility patterns in specific geographical regions to choose the best empirical antibiotics. The current study aimed to determine causative microorganisms and antibiotic resistance patterns in children diagnosed with UTI. Material and Methods: The study was carried out retrospectively with 216 children diagnosed with UTIs for the first time. The patients were categorized into two groups according to age (≤1 year and >1 year). Demographic data, presenting symptoms, imaging findings, and urine and culture analysis results were collected and compared between these two groups. Results: Cefazolin and nitrofurantoin use may be preferred in the empirical treatment of UTIs caused by Escherichia coli and Enterococcus spp. Additionally, amoxicillin/clavulanate was recommended in the empirical therapy of UTIs caused by Enterococcus spp., Klebsiella spp., and Proteus spp. The trimethoprim-sulfamethoxazole and nitrofurantoin resistance of E. coli was found to be statistically significantly higher in the ≤1 year group (p=0.03 and p=0.01, respectively), while the nitrofurantoin resistance of Klebsiella was statistically significantly higher in the >1 year group (p=0.01). The gentamicin resistance of Klebsiella spp. was statistically significantly higher in the ≤1 year group (p=0.03). Conclusion: It is important to detect regional antibiotic resistance patterns to manage UTIs and minimize related complications. Antibiotic susceptibility studies are necessary to reduce improper antibiotic use and resistance rates of antibiotics.