Prevalence and Resistance Patterns of Pediatric Urinary Tract Infections in Bahrain

Abstract

BackgroundUrinary tract infections (UTI) are a commonly encountered infection in the pediatric age group. Knowledge of the causative pathogens and their antimicrobial resistance patterns in specific geographical locations is important to provide optimum care. The aim of this study is to describe the prevalence and the antimicrobial resistance patterns of the pathogens causing UTI in the pediatric age group in one tertiary inpatient Pediatric unit in Bahrain. MethodsThis is a retrospective cross-sectional study, conducted at King Hamad University Hospital (KHUH), Bahrain. The inclusion criteria consisted of patients ≤ 14 years of age admitted to the Pediatrics department at KHUH with bacteriologically proven UTI between the months of January 2018 and May 2021. Patients who were identified to have chronic urinary tract conditions or neurodevelopmental problems involving the urinary tract were excluded from the study. Electronic medical records were used to collect data regarding the isolated pathogens and sensitivity testing results. ResultsA total of 242 cases with positive culture were included. The most common bacteria causing UTI in this sample were successively Escherichia coli (68.60%), Klebsiella pneumoniae (10.30%), Proteus mirabilis (4.69%) and Pseudomonas aeruginosa (3.31%) (p<0.01). E. coli was most resistant to cefazolin (94%), followed by ampicillin (62.68%), whilst it was most sensitive to nitrofurantoin (98.96%) followed by amikacin (98.43%) (p<0.01). K. pneumoniae showed the highest rate of resistance to ampicillin (95.24%) followed by cefazolin (83.33%), meanwhile having the highest sensitivity rate to amikacin (95.24%), followed by ciprofloxacin (90.48%). P. mirabilis had the highest resistance to cefazolin (100%) followed by nitrofurantoin (87.50%), while having the highest sensitivity to piperacillin/tazobactam (100%). ConclusionE. coli is the most common cause of UTI in the pediatric population and it was found to be most sensitive to nitrofurantoin and amikacin whilst being relatively resistant to cefazolin and ampicillin. Similarities between our study and previous studies around the world were found when comparing the antibiotics resistance patterns. Nevertheless, it is our recommendation that empirical antibiotic selection should be tailored to the local data collected from the region.

Antibiotic resistance profile of common uropathogens during COVID-19 pandemic: hospital based epidemiologic study

“…The current study confirmed earlier research that females were infected with E. coli at a greater incidence (48.0%) than males (38.2%) [ 19 ]. Only Pseudomonas was more prevalent in males than in females.…”

Prevalence of class A ESBL, class B and D carbapenemase encoding genes (CTX-M, TEM, SHV, NDM, IMP, OXA-48) in gram-negative bacterial pathogens isolated from various clinical samples collected from northern region of United Arab Emirates

“…In our study, the ESBL E. coli had shown 100% resistance to cefotaxime and ceftazidime, similarly, the study was conducted by Al-Agamy et al and Kabrah found 100% resistance to the same drugs by the ESBL E. coli [36,37]. High -medium resistance rates (97.5% -46.5%) were detected to 11 resistance to the same drugs in their studies [38][39][40][41][42]. Lower resistance rate to gentamycin (14.7%), tobramycin (12.7%), least resistance to cefoxitin (7.6%) and 100% sensitivity to 8 different antibiotics which are mentioned in Table 4.…”

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

“…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). In contrast, there was a significant difference between the percentage of E. coli (68.6% out of 242 samples) and Klebsiella spp (10.3% out of 242 samples) in urine samples of infected Bahrani infants [ 5 ]. This difference may be due to different research designs, environmental conditions, or patient selection criteria.…”

“…The most common UTI complications, such as proteinuria, high blood pressure, and kidney damage, can all come from a lack of renal function [ 4 ]. Female contraception use, personal hygiene issues, white ethnicity, a past previous UTI, a lack of water intake, neurological bladder disease, having diabetes, genitourinary instruments, being born with genitourinary abnormalities, phimosis, incomplete/infrequent urination, and prolonged constipation are all risk factors for UTI [ 5 ]. Gram-negative pathogens such as E. coli and Klebsiella spp are responsible for most UTIs [ 6 ].…”