Objective The aim of the present study was to investigate the bacterial pathogens and their resistance patterns in children presenting with their first admission for a urinary tract infection (UTI) in a large tertiary care center in Riyadh, Saudi Arabia. Methods A retrospective chart review was conducted of pediatric patients 0–14 years of age who were admitted for their first community-acquired UTI in a large tertiary care center in Riyadh, Saudi Arabia. The review covered a 6-year period (2006–2012). Results Data were obtained from 202 children, of which 162 (80.2%) were female. The most frequently isolated uropathogens were Escherichia coli (75.7%), followed by Klebsiella pneumoniae (9.4%), Pseudomonas aeruginosa (5.9%) and Enterococcus species (3.5%). Sixteen (7.9%) isolates were ESBLs. Among all uropathogens, 68% were resistant to ampicillin, 54% resistant to co-trimoxazole, and 30% resistant/intermediate sensitivity to amoxicillin/clavulinic acid. Overall, there was a low resistance rate to cefotaxime (4.4%). Conclusion E. coli is the predominant uropathogen causing UTIs in children, yet there is a high rate of multidrug-resistant organisms. For children admitted for a community-acquired UTI, a third-generation cephalosporin remains an appropriate empiric antibiotic. Our study and the work of others emphasize the importance of choosing empiric antibiotics for pediatric UTIs based on local resistance patterns.

Background: While Escherichia coli (E. coli) is the most common uropathogen implicated in urinary tract infections (UTIs) in children, some studies have found that there are different characteristics between different uropathogens in children. The aim of this study was to compare E. coli and non-E. coli UTIs in children with respect to their demographic data, predisposing factors, and imaging results. Methodology: A retrospective chart review was done in children during their first admission with urine culture confirmed UTI in a tertiary care center. We divided patients into E. coli and non-E. coli groups according to urine culture results. Results: Out of 202 children with their first admission for a culture-proven UTI, pathogens other than E. coli accounted for 24.3% of UTIs. Klebsiella pneumoniae was the most common non-E. coli pathogen, followed by Pseudomonas aeruginosa and Enterococcus species. Non-E. coli UTIs were significantly more common in male subjects, younger children, and children with a past history of UTI or who had received antibiotics prior to admission. In addition, higher rates of abnormalities on renal ultrasound and VCUG were found with non-E. coli organisms. Conclusion: There is a significant difference in demographic and imaging findings in children with non-E. coli UTIs. These findings may impact the work-up and treatment of UTIs in the pediatric population.