Evaluation of clinical, etiological and antimicrobial resistance profile of pediatric urinary tract infections in a secondary health care centre

Abstract

Background: Urinary tract infections are common during childhood. The etiologic agents and empirical antibiotics may vary due to age and geographic area. Objectives: This study was designed to investigate the urinary tract infection pathogens, their antibiotic resistance profile and risk factors in a sample of well-child population. Materials and Methods: This retrospective study was conducted in the pediatric clinics of a secondary health-care centre in a one-year period. The source of data was hospital and laboratory records. Toilet trained children and adolescents aged between 5-17 years old with positive urine culture were enrolled into the study. Microbiological studies were conducted ac- cording to international guidelines. Results: During the study 3640 urine samples were analyzed and 342(9.4%) had significant growth. Gram negative en- terobacteria were the most common infectious agents. Antibiotic susceptibility tests showed low cephalosporine resistance unless ESBL was positive. Multi drug resistance was remarkable. Extended beta lactamase resistance rate was 17%. Previous history of antibiotic use before the present administration was the only significant risk factor for ESBL positivity. Conclusion: Treating urinary tract infections may become an emerging problem soon. Unless there are risk factors, cepha- losporines are good options, but if so nitrofurantoin or carbapanems should be preferred for treatment in this population. Keywords: Urinary tract infections; antibiotics; susceptibility.