Urinary Tract Infections in Children: Clinical and Antibiotic Susceptibility Data from a Tertiary Care Hospital

Year 2023, , 234 - 240, 31.08.2023

Esra Nagehan Akyol Onder , Selçuk Türkel , Cengizhan Kılıçaslan

https://doi.org/10.29058/mjwbs.1217496

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.

Keywords

Antibiotics, children, urinary tract infection, susceptibility

Çocuklarda İdrar Yolu Enfeksiyonları: Üçüncü Basamak Bir Hastanenin Klinik ve Antibiyotik Duyarlılık Verileri

Abstract

Amaç: İdrar yolu enfeksiyonları (İYE), çocuklarda en sık görülen bakteriyel enfeksiyonlar arasındadır.
İdrar kültürü ve antibiyogram sonuçları çıkana kadar ampirik antibiyotik tedavisi önerilir. İYE tedavisi için
kullanılabilecek en uygun ampirik antibiyotik seçeneğini belirlemek için o bölgeye özgü İYE ajanlarını
ve bunların antimikrobiyal duyarlılıklarını belirlemek esastır. Bu çalışma, bölgemizde İYE tanısı alan
çocuklarda etken mikroorganizmaları ve antibiyotik direnç paternlerini belirlemeyi amaçladı.
Gereç ve Yöntemler: Çalışma, ilk kez İYE tanısı alan 216 çocuk ile retrospektif olarak gerçekleştirildi.
Hastalar yaşlarına göre (≤1 yaş ve >1 yaş) iki gruba ayrıldı. Bu iki grup arasında demografik veriler,
başvuru semptomları, görüntüleme bulguları, idrar ve kültür analiz sonuçları toplandı ve karşılaştırıldı
Bulgular: Escherichia coli ve Enterococcus türlerinin neden olduğu İYE'lerin ampirik tedavisinde sefazolin ve nitrofurantoin kullanımı tercih
edilebilir. Ayrıca, Enterococcus spp., Klebsiella spp. ve Proteus spp.'nin neden olduğu İYE'lerin ampirik tedavisinde amoksisilin/klavulanat
önerilmiştir. E. coli'nin trimetoprim-sülfametoksazol ve nitrofurantoin direnci ≤1 yaş grubunda istatistiksel olarak anlamlı yüksek bulunurken
(sırasıyla p=0,03 ve p=0,01), Klebsiella'nın nitrofurantoin direnci >1 yaş grubunda istatistiksel olarak anlamlı derecede yüksek saptandı
(p=0,01). Klebsiella türlerinin gentamisin direnci ≤1 yaş grubunda istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,03).
Sonuç: İYE'lerin tedavisinde ve komplikasyonların önlenmesinde bölgesel antibiyotik direnç paternlerini saptamak önemlidir. Uygunsuz
antibiyotik kullanımını ve antibiyotik direnç oranlarını azaltmak için antibiyotik duyarlılık çalışmaları gereklidir

Keywords

Antibiyotik, çocuk, idrar yolu enfeksiyonları, direnç

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