Antibacterial resistance patterns of pediatric community‐acquired urinary infection: Overview

Konca, Çapan; Tekin, Mehmet; Üçkardeş, Fatih; Akgün, Sadık; Almış, Habip; Bucak, İbrahim Hakan; Genc, Yeliz; Turğut, Mehmet

doi:10.1111/ped.13139

Cited by 24 publications

(41 citation statements)

References 21 publications

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“…The European Centre for Disease Prevention and Control reported an increased resistance of E. coli to empirical antibiotics like beta‐lactams 11 . From Turkey, increased uropathogen resistance to commonly used CAM, sulbactam‐ampicillin (SAM), co‐trimoxazole and third‐generation cephalosporins was shown 7,12,13 . In agreement with these results, in this study there was high resistance to ampicillin and co‐trimoxazole and isolates were relatively sensitive to amikacin and ertapenem.…”

Section: Discussionsupporting

confidence: 86%

The changing resistance patterns of bacterial uropathogens in children

Kurt-Şükür

Özçakar

Doğan

et al. 2020

Pediatrics International

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Background: Increased antimicrobial resistance is a problem in managing urinary tract infections (UTI). With this study we assessed the resistance patterns of urinary isolates in children with UTI between January 2017 and January 2018. Methods: A retrospective cohort study was conducted. Among 5,443 isolates, a total of 776 UTI episodes in 698 patients were included. Patients' gender, age, voiding dysfunction, UTI history, prophylaxis status, and presence of vesicoureteral reflux were noted. Patients were divided into three age groups: group 1 for ages ≤12 months; group 2 for ages 13-60 months; and group 3 for ages >60 months. The susceptibilities of etiologic agents to different antimicrobials were explored. Results: Median age was 54 months (range 1 month-21 years); male to female ratio was 1:5. The most common causative agent was Escherichia coli (83% of the cases), followed by Klebsiella pneumoniae (7.5%). Resistance to ampicillin (62.6%) and co-trimoxazole (39.8%) were remarkable in all isolates. Overall extended-spectrum beta-lactamase (ESBL) positivity was 23.5%. The highest resistance rates, higher ESBL positivity (28.6%), and K. pneumoniae frequency (13.5%) were observed in group 1. Ceftriaxone resistance was significantly low (0.5%) in the ESBL (À) group, which constituted the majority of the isolates. Higher resistance rates were observed among the patients on prophylaxis compared to those off prophylaxis (P < 0.001). Conclusion: Ceftriaxone can still be used for empirical treatment; however, initial urine culture results are crucial due to high ESBL positivity. Special consideration must be taken for patients under 1 year of age. Periodical surveillance studies are needed to explore the changing resistance patterns of uropathogens and modify treatment plans.

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Section: Discussionsupporting

confidence: 86%

The changing resistance patterns of bacterial uropathogens in children

Kurt-Şükür

Özçakar

Doğan

et al. 2020

Pediatrics International

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“…A similar comparative analyses were presented in other articles. Konca et al [ 46 ] presented antimicrobial resistance patterns depending on the region, time and other features, which can indicate the specific trends of antibiotic susceptibility patterns of clinical bacteria.…”

Section: Resultsmentioning

confidence: 99%

A new look at the drug-resistance investigation of uropathogenic E. coli strains

et al. 2017

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Bacterial drug resistance and uropathogenic tract infections are among the most important issues of current medicine. Uropathogenic Escherichia coli strains are the primary factor of this issue. This article is the continuation of the previous study, where we used Kohonen relations to predict the direction of drug resistance. The characterized collection of uropathogenic E. coli strains was used for microbiological (the disc diffusion method for antimicrobial susceptibility testing), chemical (ATR/FT-IR) and mathematical (artificial neural networks, Ward’s hierarchical clustering method, the analysis of distributions of inhibition zone diameters for antibiotics, Cohen’s kappa measure of agreement) analysis. This study presents other potential tools for the epidemiological differentiation of E. coli strains. It is noteworthy that ATR/FT-IR technique has turned out to be useful for the quick and simple identification of MDR strains. Also, diameter zones of resistance of this E. coli population were compared to the population of E. coli strains published by EUCAST. We observed the bacterial behaviors toward particular antibiotics in comparison to EUCAST bacterial collections. Additionally, we used Cohen’s kappa to show which antibiotics from the same class are closely related to each other and which are not. The presented associations between antibiotics may be helpful in selecting the proper therapy directions. Here we present an adaptation of interdisciplinary studies of drug resistance of E. coli strains for epidemiological and clinical investigations. The obtained results may be some indication in deciding on antibiotic therapy.

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“…1 Escherichia coli is the most common bacterial pathogen responsible for UTI. 1,2 One lingering effect of childhood UTI is that it can damage the growing kidney by forming kidney scarring associated with long-term complications, hypertension, and renal failure. [1][2][3][4] Clinical guidelines about UTI in children encourage rapid diagnosis and early treatment with an appropriate agent to prevent kidney scarring and long-term complications.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic drug resistance pattern of uropathogens seen in the first episode of community-acquired pediatric urinary tract infections at a tertiary care hospital

Sarı

Yazılıtaş

Çelebi

et al. 2021

Preprint

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BackgroundIncreased antibiotic resistance is a significant problem associated with higher morbidity, mortality, and costs in managing urinary tract infections (UTI). This study aims to analyze the antimicrobial resistance profile of uropathogens isolated from children with the first attack of community-acquired UTI.Materials and MethodsThis retrospective cohort study was conducted between January 2010-December 2016, with the patients aged one month to 18 years diagnosed with the first attack of community-acquired UTI at the pediatric outpatient clinic of a tertiary care hospital. Patients' age, sex, UTI history, clinical findings at admission, urine analysis, urine culture, and antibiogram results were recorded.ResultsA total of 1086 patients and 1086 cultures were included in the study. The male/female ratio was 1/5.3. The mean age of the children was 73.7±47.1 (0.4-215.9) months. 16.0% were aged 1-24 months. E. coli was the most common causative agent found to be 85.1% in frequency. The overall antimicrobial resistance was found to be highest for ampicillin, followed by piperacillin and trimethoprim-sulfamethoxazole (63.5, 41.6 and 38.1%, respectively). Imipenem, amikacin, and tobramycin had the least resistance (0.5, 0.5, and 7.6%, respectively). The overall antimicrobial resistance against amoxicillin-clavulanate, ampicillin-sulbactam, cefuroxime, ceftriaxone was 19.4, 24, 25.9 and 21.1%; respectively.Extended-spectrum beta-lactamase positivity was detected in 5.6% (n=61) of samples.ConclusionOur study showed significant increase in antimicrobial resistance to the most common antibiotics which are prescribed before urine culture results and antibiotic sensitivities are available. The resistance rates for amoxicillin-clavulanate, ampicillin-sulbactam, cefuroxime, ceftriaxone were almost 20% or above in children with the first UTI attack in an outpatient setting.

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Antibacterial resistance patterns of pediatric community‐acquired urinary infection: Overview

Cited by 24 publications

References 21 publications

The changing resistance patterns of bacterial uropathogens in children

The changing resistance patterns of bacterial uropathogens in children

A new look at the drug-resistance investigation of uropathogenic E. coli strains

Antibiotic drug resistance pattern of uropathogens seen in the first episode of community-acquired pediatric urinary tract infections at a tertiary care hospital

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