A decade of trends in the distribution and antimicrobial susceptibility of prevalent uropathogens among pediatric patients from Tehran, Iran during 2005–2016

Abstract

Objectives To determine changes in the distribution of uropathogens and their antimicrobial resistance in pediatric patients in a children's hospital from 2005 to 2016. Methods A cross-sectional analysis of uropathogens and their antimicrobial resistance within inpatient children was performed over the 11-year period, 2005 to 2016, in Ali Asghar children's hospital. The rate of antibiotic resistance among patients was evaluated according to demographic data including age, sex, urinary tract abnormities and history of antibiotic consumption. Results In total, 958 female and 349 male positive cultures were analyzed. Escherichia coli ( E. coli ) (77.6%) was the most common causative agent of urinary tract infection (UTI) in children and Klebsiella pneumoniae (10.4%), Pseudomonas aeruginosa (2.4%), and Enterococcus spp (2.4%) were less frequent isolated bacteria. The resistance rates of E. coli isolates were increased against amikacin, ceftriaxone, ceftazidime, ciprofloxacin, cotrimoxazole and imipenem from 2005 to 2010. However, we observed a decreasing trend for some of antibiotics including amikacin, gentamicin, imipenem, ceftazidime and cotrimoxazole during 2014–2016. The rate of antibiotic resistance was greater in boys than in girls against many antibiotics. The rate of resistance to amikacin, gentamicin, nitrofurantoin and cotrimoxazole in patients aged <1 year was higher than other age groups ( p <0.001). A higher antibiotic resistance rate was observed in patients with anatomical abnormality and those who have had a history of antibiotic consumption. Conclusion The study indicated the significant decrease in E. coli antibiotic resistance in the last 3 years. An effective empirical treatment regime should be based on local epidemiology and antimicrobial susceptibility testing.

Bacterial Profile and Antibiotic Susceptibility Patterns of Urinary Tract Infection Among Children in Karbala Teaching Hospital

“…These results concur with a study conducted in 2021 in Tehran, which identified E. coli as the most frequent etiological agent underlying UTI in children (77.6%) [19]. Other studies from additional nations have confirmed this finding [20][21].…”

“…Two previous studies, from France in 2017 [27] and from Greece in 2020 [28] determined that amikacin was the optimal antibiotic for treating UTIs in children and infants; those results concur with the sensitivities identified in this study. However, in contrast, a 2021 study from Tehran, Iran reported the high degree of resistance of Gram-negative organisms to amikacin, ceftriaxone, and imipenem [29]. A study conducted in Pakistan also described organisms that were extremely resistant to a range of antimicrobial agents like cefixime, ceftriaxone, ciprofloxacin, and nalidixic acid [30].…”

Etiology, Sensitivity and Resistance Pattern of Urinary Tract Infection Among Children (0 To 16 Years)

“…Eleven year prolong study conducted from 2005-2016 at Iran shows resistance pattern of Pseudomonas as follows 6.9 % resistance to amikacin, 100% resistance to ampicillin, 46.15% resistance to ceftriaxone, 4% resistance to ciprofloxacin, and 83.87% resistance to nitrofurantoin. 27 Following is the resistance pattern of our study for Pseudomonas: none of the isolates of pseudomonas was resistance to amikacin 1.3 % resistant to ampicillin, 1.2% and 0.9% resistance to ciprofloxacin and ceftriaxone respectively and 18.2% isolates were resistant to nitrofurantoin.…”

Bacterial Diversity and Antibiotic Resistance Patterns of Community-Acquired Urinary Tract Infections in Mega Size Clinical Samples of Egyptian Patients: A Cross-Sectional Study

“…It is worth mentioning that in our study, the male infants showed a higher total number of positive cultures (56%) than female infants (44%). The difference might be attributed to young males' lack of circumcision at this age [ 20 ]. Interestingly, our statistical results showed that Egyptian infants (less than one year) were equally susceptible to E. coli and Klebsiella spp (36% and 38%, respectively).…”