Abstract
BackgroundUrinary tract infections (UTI) are a commonly encountered infection in the pediatric age group. Knowledge of the causative pathogens and their antimicrobial resistance patterns in specific geographical locations is important to provide optimum care. The aim of this study is to describe the prevalence and the antimicrobial resistance patterns of the pathogens causing UTI in the pediatric age group in one tertiary inpatient Pediatric unit in Bahrain.MethodsThis is a retrospective cross-sectional study, conducted at King Hamad University Hospital (KHUH), Bahrain. The inclusion criteria consisted of patients ≤ 14 years of age admitted to the Pediatrics department at KHUH with bacteriologically proven UTI between the months of January 2018 and May 2021. Patients who were identified to have chronic urinary tract conditions or neurodevelopmental problems involving the urinary tract were excluded from the study. Electronic medical records were used to collect data regarding the isolated pathogens and sensitivity testing results.ResultsA total of 242 cases with positive culture were included. The most common bacteria causing UTI in this sample were successively Escherichia coli (68.60%), Klebsiella pneumoniae (10.30%), Proteus mirabilis (4.69%) and Pseudomonas aeruginosa (3.31%) (p<0.01). E. coli was most resistant to cefazolin (94%), followed by ampicillin (62.68%), whilst it was most sensitive to nitrofurantoin (98.96%) followed by amikacin (98.43%) (p<0.01). K. pneumoniae showed the highest rate of resistance to ampicillin (95.24%) followed by cefazolin (83.33%), meanwhile having the highest sensitivity rate to amikacin (95.24%), followed by ciprofloxacin (90.48%). P. mirabilis had the highest resistance to cefazolin (100%) followed by nitrofurantoin (87.50%), while having the highest sensitivity to piperacillin/tazobactam (100%).ConclusionE. coli is the most common cause of UTI in the pediatric population and it was found to be most sensitive to nitrofurantoin and amikacin whilst being relatively resistant to cefazolin and ampicillin. Similarities between our study and previous studies around the world were found when comparing the antibiotics resistance patterns. Nevertheless, it is our recommendation that empirical antibiotic selection should be tailored to the local data collected from the region.
Highlights
Urinary tract infections (UTIs) are a commonly encountered infection in the pediatric age group both in the community as well as in the hospital setting [1]
Symptoms of UTI in infants and children up to two years of life include fever and occasionally symptoms of sepsis. They may present with crying whilst voiding, change in urine color or a poor stream [5], whereas children older than two years of age with cystitis will present with urinary urgency, frequency, How to cite this article Shaaban O A, Mahmoud N A, Zeidan A A, et al (December 31, 2021) Prevalence and Resistance Patterns of Pediatric Urinary Tract Infections in Bahrain
The results showed that the frequencies of the other three predominant organisms (K. pneumoniae, P. mirabilis,and P. aeruginosa) were higher in males, there was no significant difference between males and females (p value between males and females = 0.84, 1.00, and 0.48 for K. pneumoniae, P. mirabilis, and P. aeruginosarespectively)
Summary
Urinary tract infections (UTIs) are a commonly encountered infection in the pediatric age group both in the community as well as in the hospital setting [1]. Symptoms of UTI in infants and children up to two years of life include fever and occasionally symptoms of sepsis They may present with crying whilst voiding, change in urine color or a poor stream [5], whereas children older than two years of age with cystitis will present with urinary urgency, frequency, How to cite this article Shaaban O A, Mahmoud N A, Zeidan A A, et al (December 31, 2021) Prevalence and Resistance Patterns of Pediatric Urinary Tract Infections in Bahrain.
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