In vitro Antimicrobial Susceptibility of Urinary Tract Infection Pathogens in Children

INTRODUCTION: Urinary tract infection (UTI) is one of the most common bacterial infections in children. Empirical treatment is commenced according to the patient's characteristics and the antimicrobial susceptibility patterns in the region. Therefore, determination of antimicrobial resistance patterns has a great importance for effective treatment. The aim of this study is to determine the pathogens that cause urinary tract infections in patients admitted to a university hospital in Izmir and to determine their antimicrobial susceptibility pattern.
METHODS: The files of patients aged between 0-18 years, followed up with diagnosis of urinary tract infection, vesicoureteral reflux and neurogenic bladder in Ege University Pediatric Nephrology Unit between February 2013 and November 2018 were retrospectively reviewed.
RESULTS: A total of 1126 positive urine cultures from 279 patients (65%female) were included into the study. Gram-negative pathogens constituted 88.2% of the cultures. Escherichia coli (E. coli) was the most common isolated bacteria with a prevalence of 59.1% followed by Klebsiella pneumonia with 17.9 %, Enterococcus faecalis 8.3 % (n= 93). Ampicillin, cefuroxime and trimethoprim-sulfamethoxazole with susceptibility rates of 18.6%, 39.6%, 49.0% respectively, constitute of the highest resistant antimicrobials to Enterobacteriaceae. Enterococcus spp. showed the highest resistance to gentamycin with 50% resistance to tested cases. Pseudomonas spp. with 64.3% susceptibility, showed the highest resistance to piperacillin-tazobactam
DISCUSSION AND CONCLUSION: This study reveals that bacterial resistance to commonly used antimicrobials in UTI is an important and challenging problem that requires planning.