Pediatric - specific Antimicrobial Resistance Patterns of Urinary Tract Infections: A Single - Centre Experience from Turkey

Year 2016, Volume: 43 Issue: 4, 508 - 514, 25.12.2016

Yasar Kandur Sevinc Ozden Bahar Buyukkaragoz

Abstract

Objectives: Antimicrobial resistance of the causative
microorganisms of pediatric urinary tract infection (UTI) is a growing
problem. The aim of this study is to determine the changing pattern of
antibiotic susceptibility in UTIs in an outpatient setting.

Methods: We retrospectively reviewed the medical
records of pediatric patients with UTI who were followed-up in our
center between January-2014 and May-2015.

Results: One hundred and seventy-one patients (M/F=
53/118; mean age 56 ± 47.2 months) with UTI were enrolled in this study.
A total of 231 urinary pathogens were isolated from UTI episodes. The
most common causative agent was Escherichia coli (E. coli) (70.6%)
followed by Klebsiella spp. (16.5%), Proteus spp. (6.5%). One point
eight percent of E. coli isolates were resistant to amikacin, 17.8% to
gentamicin, 60.7% to TMP-SMX, 66,9% to ampicillin, 52.1% to cefixime,
46% to ceftriaxone, 54.6% to cefuroxime and 4.9% to nitrofurantoin.

Conclusions: TMP-SMX and nitrofurantoin are poor
empirical choices for pediatric patients due high resistance rates and
gastrointestinal side effects, respectively. Second and third
-generation cephalosporins (cefixime) may not be considered as
appropriate empiric antibiotic alternatives anymore given their high
resistance rates in the next few years. Physicians who work in the
primary health care should be encouraged for the selection of more
appropriate antibiotics.

Keywords

Urinary tract infection, antimicrobial resistance

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