Etiological and Resistance Profile of Bacteria Involved in Urinary Tract Infections in Young Children

Abstract

Background. The objective of this study was to identify the bacteria most frequently responsible for urinary tract infection (UTI) in the population of under-2-year-olds in our geographic area and to evaluate the activity of antibiotics widely used for UTI treatment during a 4-year study period. Materials and Methods. A retrospective analysis was conducted of data on the identification and susceptibility of microorganisms isolated in urine samples from children under 2 years of age. Results. A total of 1,045 uropathogens were isolated. Escherichia coli accounted for the majority (60.3%) of these, followed by Enterococcus faecalis (22.4%) and Klebsiella spp. (6.5%). The highest E. coli susceptibility rates (>90%) were to piperacillin-tazobactam, cefuroxime, cefotaxime, ceftazidime, imipenem, gentamicin, nitrofurantoin, and fosfomycin, and the lowest were to amoxicillin-clavulanic acid and cotrimoxazole. Among all bacteria isolated, we highlight the overall high activity of piperacillin-tazobactam, imipenem, nitrofurantoin, and fosfomycin against both community and hospital isolates and the reduced activity of amoxicillin-clavulanic acid, cephalosporins, gentamicin, and cotrimoxazole. There was no significant change in the total activity of any of the studied antibiotics over the 4-year study period. Conclusion. Empiric treatment with amoxicillin-clavulanic acid, cotrimoxazole, cephalosporins, and gentamicin may be inadequate due to their limited activity against uropathogens in our setting.

Comparison of Primary and Recurrent Urinary Tract Infections in Children

“…In that study, Escherichia coli was found in 60.3% of the samples, and it was followed by Enterococcus faecalis (22.4%) and Klebsiella spp. (6.5%) [9]. Similarly, another study reported that Escherichia coli was the most common responsible pathogen (51.5%), and it was followed by Klebsiella spp.…”

Etiological characteristic and risk factors of ESBL-Urinary Tract Infections: A nomogram had been built and Urologist should act in time

“…pneumoniae was more common among the pathogens [20] . On the other hand, the prevalence of Enterococcus species is reported higher in children with underlying urological malformations [21] .…”

Prevalence and antibiotic susceptibility of urinary tract infections in febrile children below ten years attending mulago hospital, Uganda

“…These findings concur with those in similar studies carried out in Europe and Asia. The predominance of Enterobacteriaceae could be due to their omnipresence in the environment (18,19). Furthermore, Escherichia coli is the most predominant normal aerobic intestinal flora with various strains of specific virulence factors that interact with the host to overcome host defenses in the urinary tract and to stimulate an infection.…”

“…This could also be due to the poor toilet manners amongst children. Escherichia coli ascend to the urinary tract thus becoming pathogenic (19).…”

“…The successful initial empirical treatment is based on susceptibility and resistance patterns obtained from local data, yet these patterns are dynamic. Periodic monitoring of resistance to antibiotic agents is essential to establish standard treatment guidelines for UTIs in children (9,19,24).…”