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Microbiological and Antimicrobial Profile of Urinary System Infections in Children in Uşak

Yıl 2022, Cilt: 4 Sayı: 3, 345 - 349, 22.09.2022
https://doi.org/10.37990/medr.1101861

Öz

Aim: One of the most prevalent pediatric diseases is urinary tract infection (UTI), accounting for 3% of all infections among the pediatric population and affect 2% of males and 8% of females by age seven. Bacteria are the most prevalent cause of UTIs, accounting for more than 95 percent of cases. The most prevalent causal bacteria of UTI is Escherichia coli. Antibiotics are included in the treatment of these infections. As a result, determining the correct antibiotic susceptibility is critical in the therapeutic treatment of bacterial infections. This study aimed to analyse the aetiology and antimicrobial resistance characteristics of urinary tract infection among children presenting with symptoms in Uşak.
Material and Method: A total of 1250 urine culture results were retrospectively analyzed from pediatric patients aged 0–16 years who were admitted to Uşak Öztan Hospital as outpatients with symptoms and complaints of urinary tract infection and whose urine analysis and urine culture were taken between January 2018 and December 2020.
Result: Gram-negative microorganism growth was found in 238 (19%) of the 1250 pediatric patients evaluated in our study. There was no growth in the urine cultures of 877 (70%) patients. E. coli was the most isolated microorganism in our study, which was detected in 168 (70.5%) of the patients.
Conclusions: We present the first antimicrobial resistance data for the city of Uşak. Our study showed that amoxicillin/clavulanate is not the best option for the empirical therapy of community acquired UTIs, contrary to current local practice. In addition, ceftriaxone was found to be the second most resistant antibiotic in our study.

Kaynakça

  • 1- Gurel S, Onal ZE, Akıcı N, Nuhoglu C. Correspondence of Priority between DMSA Scintigraphy and Voiding Cystourethrography in Children with Urinary Tract Infections. The Medical Journal of Haydarpaşa Numune Training and Research Hospital. 2015;55 (1): 22-30
  • 2. Doern CD, Richardson SE. Diagnosis of urinary tract infections in children. Kraft CS, ed J Clin Microbiol 2016;54(9):2233–2242.
  • 3. Wang J, He L, Sha J, Zhu H, Huang L, Zhu X, et al. Etiology and antimicrobial resistance patterns in pediatric urinary tract infection. Pediatr Int. 2018;60(5):418-422.
  • 4. Jorgensen JH, Ferraro MJ. Antimicrobial susceptibility testing: a review of general principles and contemporary practices. Clin Infect Dis. 2009;49(11):1749–55.
  • 5. Subcommittee on Urinary Tract Infection, Steering Comimittee on Quality Improvement and Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128:595-610.
  • 6. Yakubov R, van den Akker M, Machamad K, Hochberg A, Nadir E, Klein A. Antimicrobial Resistance Among Uropathogens That Cause Childhood Community-acquired Urinary Tract Infections in Central Israel. Pediatr Infect Dis J. 2017;36(1):113-115.
  • 7. Gunduz S, Uludağ Altun H. Antibiotic resistance patterns of urinary tract pathogens in Turkish children. Glob Health Res Policy. 2018;16:3-10.
  • 8. Vandepitte J, Engbaek K, Piot P, Heuck CC, et al. Basic laboratory procedures in clinical bacteriology. 2nd ed. Geneva: World Health Organization; 2003.
  • 9. Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW. (ed). Manual of clinical microbiology. 10th ed. American Society of Microbiology; 2011.
  • 10. Pitout JD, Laupland KB. Extended-spectrum ß-lactamase producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect. Dis. 2008;8:159–66.
  • 11. Rezaee MA, Abdinia B. Etiology and Antimicrobial Susceptibility Pattern of Pathogenic Bacteria in Children Subjected to UTI: A Referral Hospital-Based Study in Northwest of Iran. Medicine. 2015;94(39): e1606.
  • 12. McLellan LK, Hunstad DA. Urinary tract infection: pathogenesis and outlook. Trends Mol Med. 2016;22(11):946–57.
  • 13. Kalal and Patel. Microbiological and Antimicrobial Profile of Urinary Tract Infection in Children from a Teaching Hospital in South India. J Pediatr Inf. 2017; 11: i19-i22
  • 14. Konca C, Tekin M, Uckardes F, Akgun S, Almis H, Bucak IH, et al. Antibacterial resistance patterns of pediatric community-acquired urinary infection: Overview. Pediatr Int. 2017;59(3):309-315.
  • 15. Yolbaş I, Tekin R, Kelekci S, Tekin A, Okur MH, Ece A et al. Community-acquiredurinary tractinfections in children: pathogens, antibiotic susceptibility and seasonal changes. Eur Rev Med Pharmacol Sci. 2013;17(7):971-6.
  • 16. De Miranda ÉJP, De Oliveira GSS, Roque FL, Dos Santos SR, Olmos RD, Lotufo PA. Susceptibility to antibiotics in urinary tract infections in a secondary care setting from 2005-2006 and 2010-2011, in São Paulo, Brazil: data from 11,943 urine cultures. Rev Inst Med trop S Paulo. 2014;56:313–24.
  • 17. Edlin RS, Copp HL. Antibiotic resistance in pediatric urology. Ther Adv Urol. 2014;6:54-61
  • 18. Özçakar ZB, Yalçınkaya F, Kavaz A, Kadıoğlu G, Elhan AE, Aysev D, et al. Urinary infections owing to ESBL-producing bacteria: microorganisms change – clinical pattern does not. Act. Paediatr. 2011;100:61-4
  • 19. Pourakbari B, Ferdosian F, Mahmoudi S, Teymuri M, Sabouni F, Heydari H, et al. Increase resistant rates and ESBL production between E. coli isolates causing urinary tract infection in young patients from Iran. Braz J Microbiol. 2012;43(2):766-9.
  • 20. Uyar Aksu N, Ekinci Z, Dündar D, Baydemir C. Childhood urinary tract infection caused by extended-spectrum β-lactamase-producing bacteria: Risk factors and empiric therapy. Pediatr Int. 2017;59(2):176-180.
  • 21. Akturk H, Sutcu M, Somer A, Karaman S, Acar M, Unuvar A, et al. Results of Four-Year Rectal Vancomycin-Resistant Enterococci Surveillance in a Pediatric Hematology-Oncology Ward: From Colonization to Infection. Turkish journal of hematology: official journal of Turkish Society of Haematology. 2016;33(3):244-7.
  • 22. Shortridge D, Duncan LR, Pfaller MA, Flamm RK. Activity of ceftolozane-tazobactam and comparators when tested against Gram-negative isolates collected from paediatric patients in the USA and Europe between 2012 and 2016 as part of a global surveillance programme. Int J Antimicrob Agents. 2019;53(5):637-643.
  • 23. Atmis B, Kara SS, Aslan MH. Community-acquired Pediatric Urinary Tract Infections Caused by Morganella Morganii. J Pediatr Res. 2020;7(2):121-5.
  • 24. Kalaitzidou I, Ladomenou F, Athanasopoulos E, Anatoliotaki M, Vlachaki G. Susceptibility patterns of uropathogens identified in hospitalized children. Pediatr Int. 2019;61(3):246-251.

Uşak İlinde Çocuklarda Üriner Sistem Enfeksiyonlarının Mikrobiyolojik ve Antimikrobiyal Profili

Yıl 2022, Cilt: 4 Sayı: 3, 345 - 349, 22.09.2022
https://doi.org/10.37990/medr.1101861

Öz

Amaç: En yaygın pediatrik hastalıklardan biri, pediatrik popülasyondaki tüm enfeksiyonların %3’ünü oluşturan ve yedi yaşına kadar erkek çocukların %2’sini ve kız çocuklarının %8’ini etkileyen idrar yolu enfeksiyonudur (İYE). Bakteriler, vakaların yüzde 95’inden fazlasını oluşturan İYE’lerin en yaygın nedenidir. İYE’n de en sık izole eden bakteri Escherichia coli’dir. Antibiyotikler idrar yolu enfeksiyonların tedavisinin temelini oluşturur. Sonuç olarak, bakteriyel enfeksiyonların terapötik tedavisinde doğru antibiyotik duyarlılığının belirlenmesi kritik öneme sahiptir. Bu çalışmada Uşak’ta belirgin İYE semptomları ile başvuran çocuklarda idrar yolu enfeksiyonunun etiyolojisi ve antimikrobiyal direnç özelliklerinin incelenmesi amaçlanmıştır.
Materyal ve Metot: Uşak Öztan Hastanesi’ne ayaktan idrar yolu enfeksiyonu semptom ve şikayetleri ile başvuran, 2018 Ocak-2020 Aralık ayları arasında idrar tahlili ve idrar kültürü alınan 0-16 yaş arası çocuk hastalardan toplam 1250 idrar kültürü sonucu retrospektif olarak incelendi.
Bulgular: Çalışmamızda değerlendirilen 1250 pediyatrik hastanın 238’inde (%19) gram negatif mikroorganizma üremesi bulundu. 877 (%70) hastanın idrar kültüründe üreme olmadı. Çalışmamızda hastaların 168’inde (%70,5) E. coli en fazla izole edilen mikroorganizma E. coli idi.
Sonuçlar: Uşak ili için ilk antimikrobiyal direnç verilerini sunuyoruz. Çalışmamız, mevcut yerel uygulamanın aksine, toplum kökenli İYE’lerin ampirik tedavisi için amoksisilin/klavulanatın en iyi seçenek olmadığını göstermiştir. Ayrıca çalışmamızda seftriakson en dirençli ikinci antibiyotik olarak bulundu.

Kaynakça

  • 1- Gurel S, Onal ZE, Akıcı N, Nuhoglu C. Correspondence of Priority between DMSA Scintigraphy and Voiding Cystourethrography in Children with Urinary Tract Infections. The Medical Journal of Haydarpaşa Numune Training and Research Hospital. 2015;55 (1): 22-30
  • 2. Doern CD, Richardson SE. Diagnosis of urinary tract infections in children. Kraft CS, ed J Clin Microbiol 2016;54(9):2233–2242.
  • 3. Wang J, He L, Sha J, Zhu H, Huang L, Zhu X, et al. Etiology and antimicrobial resistance patterns in pediatric urinary tract infection. Pediatr Int. 2018;60(5):418-422.
  • 4. Jorgensen JH, Ferraro MJ. Antimicrobial susceptibility testing: a review of general principles and contemporary practices. Clin Infect Dis. 2009;49(11):1749–55.
  • 5. Subcommittee on Urinary Tract Infection, Steering Comimittee on Quality Improvement and Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128:595-610.
  • 6. Yakubov R, van den Akker M, Machamad K, Hochberg A, Nadir E, Klein A. Antimicrobial Resistance Among Uropathogens That Cause Childhood Community-acquired Urinary Tract Infections in Central Israel. Pediatr Infect Dis J. 2017;36(1):113-115.
  • 7. Gunduz S, Uludağ Altun H. Antibiotic resistance patterns of urinary tract pathogens in Turkish children. Glob Health Res Policy. 2018;16:3-10.
  • 8. Vandepitte J, Engbaek K, Piot P, Heuck CC, et al. Basic laboratory procedures in clinical bacteriology. 2nd ed. Geneva: World Health Organization; 2003.
  • 9. Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW. (ed). Manual of clinical microbiology. 10th ed. American Society of Microbiology; 2011.
  • 10. Pitout JD, Laupland KB. Extended-spectrum ß-lactamase producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect. Dis. 2008;8:159–66.
  • 11. Rezaee MA, Abdinia B. Etiology and Antimicrobial Susceptibility Pattern of Pathogenic Bacteria in Children Subjected to UTI: A Referral Hospital-Based Study in Northwest of Iran. Medicine. 2015;94(39): e1606.
  • 12. McLellan LK, Hunstad DA. Urinary tract infection: pathogenesis and outlook. Trends Mol Med. 2016;22(11):946–57.
  • 13. Kalal and Patel. Microbiological and Antimicrobial Profile of Urinary Tract Infection in Children from a Teaching Hospital in South India. J Pediatr Inf. 2017; 11: i19-i22
  • 14. Konca C, Tekin M, Uckardes F, Akgun S, Almis H, Bucak IH, et al. Antibacterial resistance patterns of pediatric community-acquired urinary infection: Overview. Pediatr Int. 2017;59(3):309-315.
  • 15. Yolbaş I, Tekin R, Kelekci S, Tekin A, Okur MH, Ece A et al. Community-acquiredurinary tractinfections in children: pathogens, antibiotic susceptibility and seasonal changes. Eur Rev Med Pharmacol Sci. 2013;17(7):971-6.
  • 16. De Miranda ÉJP, De Oliveira GSS, Roque FL, Dos Santos SR, Olmos RD, Lotufo PA. Susceptibility to antibiotics in urinary tract infections in a secondary care setting from 2005-2006 and 2010-2011, in São Paulo, Brazil: data from 11,943 urine cultures. Rev Inst Med trop S Paulo. 2014;56:313–24.
  • 17. Edlin RS, Copp HL. Antibiotic resistance in pediatric urology. Ther Adv Urol. 2014;6:54-61
  • 18. Özçakar ZB, Yalçınkaya F, Kavaz A, Kadıoğlu G, Elhan AE, Aysev D, et al. Urinary infections owing to ESBL-producing bacteria: microorganisms change – clinical pattern does not. Act. Paediatr. 2011;100:61-4
  • 19. Pourakbari B, Ferdosian F, Mahmoudi S, Teymuri M, Sabouni F, Heydari H, et al. Increase resistant rates and ESBL production between E. coli isolates causing urinary tract infection in young patients from Iran. Braz J Microbiol. 2012;43(2):766-9.
  • 20. Uyar Aksu N, Ekinci Z, Dündar D, Baydemir C. Childhood urinary tract infection caused by extended-spectrum β-lactamase-producing bacteria: Risk factors and empiric therapy. Pediatr Int. 2017;59(2):176-180.
  • 21. Akturk H, Sutcu M, Somer A, Karaman S, Acar M, Unuvar A, et al. Results of Four-Year Rectal Vancomycin-Resistant Enterococci Surveillance in a Pediatric Hematology-Oncology Ward: From Colonization to Infection. Turkish journal of hematology: official journal of Turkish Society of Haematology. 2016;33(3):244-7.
  • 22. Shortridge D, Duncan LR, Pfaller MA, Flamm RK. Activity of ceftolozane-tazobactam and comparators when tested against Gram-negative isolates collected from paediatric patients in the USA and Europe between 2012 and 2016 as part of a global surveillance programme. Int J Antimicrob Agents. 2019;53(5):637-643.
  • 23. Atmis B, Kara SS, Aslan MH. Community-acquired Pediatric Urinary Tract Infections Caused by Morganella Morganii. J Pediatr Res. 2020;7(2):121-5.
  • 24. Kalaitzidou I, Ladomenou F, Athanasopoulos E, Anatoliotaki M, Vlachaki G. Susceptibility patterns of uropathogens identified in hospitalized children. Pediatr Int. 2019;61(3):246-251.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Özgün Makaleler
Yazarlar

Selçuk Gürel 0000-0001-5300-9795

Mehmet Uçar 0000-0003-3998-8143

Yayımlanma Tarihi 22 Eylül 2022
Kabul Tarihi 24 Mayıs 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 4 Sayı: 3

Kaynak Göster

AMA Gürel S, Uçar M. Microbiological and Antimicrobial Profile of Urinary System Infections in Children in Uşak. Med Records. Eylül 2022;4(3):345-349. doi:10.37990/medr.1101861

 Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Turkey

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Turkey

E-mail: medrecsjournal@gmail.com

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