Pathogenic microorganisms and antimicrobial resistance patterns in the pediatric age group with urinary system infections

Abstract

Objectives: Urinary system infections (UTIs) are among the most common infections affecting the pediatric age group. We aim to show the distribution of pathogenic microorganisms and antimicrobial resistance patterns of urinary tract infections (UTIs) and select the most appropriate antibiotherapy in the pediatric age group. Also, we wanted to determine signs and symptoms, predisposing factors, and imaging findings in UTIs. Material and Methods: In this study, the Elazığ Fethi Sekin City Hospital health registry system was screened retrospectively to obtain data about the results of urinalysis, urine culture tests, and urinary imaging findings of patients, who presented to the pediatric nephrology clinic with signs and symptoms of UTI between January 2020 and September 2021. The study population consisted of children aged 1 month to 18 years. Results: The study sample included 191 patients. Antimicrobial resistance of E. coli was seen at the highest level to ampicillin (55%), followed by amoxicillin (42%), trimethoprim-sulfamethoxazole (TMP-SMX) (36%), and cefuroxime (35%). The antimicrobial resistance of Klebsiella pneumoniae was seen most frequently in patients treated with ampicillin (100%), amoxicillin (50%), ceftazidime (31%), and nitrofurantoin (31%). The antimicrobial resistance of Proteus mirabilis was seen mostly in cases that received nitrofurantoin (88%), and TMP-SMX (55%). Enterobacter aerogenes demonstrated minimal antimicrobial sensitivity to ampicillin (66%), amoxicillin (33%), and nitrofurantoin (33%) in decreasing order of frequency. Conclusions: The rate of resistance to ampicillin is very high in Klebsiella pneumoniae and in Enterobacter spp and rates of antimicrobial resistance to cephalosporin, TMP-SMX, and nitrofurantoin are increasing. The rational use of antibiotics is a globally important issue.