Antibiotic Resistance Patterns in Pediatric Urinary Tract Infections: A Comparison Between 2013-2015 and 2019-2021 Pediatrik İdrar Yolu Enfeksiyonlarında Antibiyotik Direnç Paternleri: 2013-2015 ve 2019-2021 Arasında Bir Karşılaştırma

Abstract

Giriş ve Amaç: İdrar yolu enfeksiyonları (İYE) çocuklarda en sık görülen enfeksiyonlardan biridir. Bu çalışmanın amacı 2013-2015 ve 2019-2021 yılları arasında idrar kültürlerinin etiyoloji ve antibiyotik duyarlılık sonuçlarını değerlendirmek, karşılaştırmak ve yıllar içindeki lokal epidemiyolojik farkı ortaya koymaktır. Gereç ve Yöntemler: Bu çalışmaya üreme olan 1000 idrar kültürü (2013-2015 ve 2019-2021 dönemleri için 500'er kültür) ve antibiyogram sonuçları dahil edildi. Bulgular: Her iki yıl aralığında da idrar kültürlerinde en çok saptanan üropatojenler E. coli ve Klebsiella türleri olarak bulundu. E. coli ve Klebsiella türleri ampisilin, amoksisilin, trimetoprim-sulfametoksazol, sefuroksim ve seftriakson'a karşı yüksek direnç göstermiştir. E. coli'nin ampisilin, amoksisilin ve trimetoprim-sulfametoksazole direnç oranları sırasıyla %65, %46 ve %45 olarak bildirilmiş ve 2019-2021 yılları arasında anlamlı olarak artmıştır (sırasıyla p <0,001, p <0,001, p = 0,003). Bu iki çalışma döneminde Klebsiella, Proteus ve Enterococcus türlerinin antibiyotiklere direnç oranlarında anlamlı bir fark saptanmamıştır. Sonuç: E. coli'ye karşı en sık kullanılan antibiyotikler olan ampisilin, amoksisilin, trimethoprim-sulfametaksazolün en yüksek direnç oranlarına sahip olduğu görüldü. İYE'lerde ampirik antibiyotik önerileri için yerel kılavuzları yeniden düzenlemek amacı ile antibiyotiklerin yerel duyarlılıklarını araştırmak önemlidir.

Keywords

• Antibiotic therapy
• antimicrobial resistance
• child
• urinary tract infections.

Antibiotic Resistance Patterns in Pediatric Urinary Tract Infections: A Comparison Between 2013-2015 and 2019-2021

Abstract

Objective: Urinary tract infections (UTIs) are one of the most common infections in children. The aim of this study was to assess and compare the etiology and antibiotic susceptibility results of urine cultures obtained between 2013-2015 and 2019-2021 and evaluate local epidemiologic differences over years. Materials and Methods: A total of 1,000 samples with positive urine cultures (500 cultures each for the 2013-2015 and 2019-2021 periods) and antibiogram results were included in this study. Results: The most grown uropathogens were Escherichia coli and Klebsiella spp. in both two periods. E. coli and Klebsiella spp. showed high resistance to ampicillin, amoxicillin, trimethoprim-sulfamethoxazole, cefuroxime, and ceftriaxone. The resistance rates of E. coli to ampicillin, amoxicillin and trimethoprim-sulfamethoxazole were reported as 65%, 46%, and 45%, respectively and significantly increased in 2019-2021 compared to 2013-2015 (p<0.001, p<0.001, and p=0.003, respectively). There was no significant difference in the resistance rates of Klebsiella, Proteus and Enterococcus spp. to antibiotics during the two-study period. Conclusion: It was observed that the most commonly used antibiotics, ampicillin, amoxicillin, trimethoprim-sulfamethoxazole, against E. coli had the highest resistance rates. It is important to confirm the local susceptibility patterns of antibiotics to revise local guidelines in terms of empirical antibiotic recommendations in UTIs.

Keywords

• Antibiotic therapy
• antimicrobial resistance
• child
• urinary tract infections.

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