Diagnosis and Antibiotic Resistance of Enterococcus Spp. Causing Urinary Tract Infections in Children

Abstract

Introduction: Among Gram-positive bacteria, enterococci are considered the most frequent pathogens in the case of urinary tract infections (UTIs) in children. It is known that enterococci have intrinsic resistance and acquired resistance is achieved by different mechanisms for: beta-lactams, aminoglycosides, quinolones, glycopeptides and linezolid. Objectives: The purpose of this review is to demonstrate that Enterococcus spp. is a frequent cause of urinary infections in children and to analyze antibiotic resistance. Materials and methods: The research was conducted using specific keywords such as “antibiotic resistance”, “children”, “UTI”, “Enterococcus spp.”, and “biofilm”, in specialty books, Google Scholar, PubMed, ScienceDirect and PubMed Central (PMC). Results: Antibiotic resistance of Enterococcus spp. is an issue in the choice of treatment for urinary tract infections. According to certain research, resistance to vancomycin has increased in some countries while decreasing in others. Another concerning problem is the observed gentamicin resistance, notably in Enterococcus faecium. Discussion: Virulence factors, particularly Esp, which is involved in biofilm formation, play a key role in the processes of antibiotic resistance development. The presence of vanA and vanB genes modifies the structure of the bacteria and leads to the emergence of antibiotic resistance. Enterococcal resistance to vancomycin (VRE) represents a major public health problem and is the main mechanism that occurs in nosocomial infections. Conclusions: Enterococcus spp. is one of the most prevalent etiological agents in urinary pathology and a common source of nosocomial infections. Because of the presence of virulence factors and genes, these bacteria can easily acquire resistance to specific antibiotics. Keywords: antibiotic resistance, children, UTI, Enterococcus spp., biofilm