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.