Incidence of antibiotics resistance among uropathogens in Omani children presenting with a single episode of urinary tract infection

Abstract

Urinary tract infection (UTI) is one of the most common community-acquired infections. Different organisms can be the cause of UTI in children, with resistance to antibiotics becoming a significant problem in the choice of treatment. Worldwide studies have documented the prevalence of uropathogens in different countries. However, there is no previous study documenting the incidence of different uropathogens in Oman. We aim to report the most common uropathogens and their antibiotic sensitivity patterns in children presenting with documented, single episode UTI at a tertiary hospital in Oman. A retrospective analysis of all Omani children below 14 years who presented with a case of first documented UTI to SQUH between September 2008 and August 2012 was conducted. Data were obtained from the patients' electronic records in the hospital information system. Data were then analyzed using SSPS (Statistical Package for Social Sciences program, Version 20, IBM, Chicago, IL, USA). In the retrospective review of all urine cultures, 438 positive urine cultures were identified. Out of those, 208 (47.5%) belonged to children with their first episode of UTI. Thirty-three patients were excluded and 75 patients were included in the final analysis. Escherichia coli was the most frequently encountered uropathogen in our cohort (69%), followed by Klebsiella pneumoniae infection (17%). Nearly half (46.6%) of these two common organism were resistant to Cotrimoxazole, while 31% of them were resistant to Augmentin. Twenty-four percent of the E. coli and K. pneumoniae strains were resistant to Cefuroxime, and only 10% were resistant to nitrofurantoin. Both Augmentin and Cotrimoxazole should not be the first line antibiotics to treat UTI.

Community-acquired urinary tract infections in children

“…The bacteriologic profile and resistance patterns of uropathogens found in our study are consistent with the most recently published regional study in children from Oman [3]. E. coli, in particular, accounted for over two-thirds of all UTIs in children, with K. pneumonia e being the second most common uropathogen.…”

“…Almost half of these two organisms were resistant to co-trimoxazole, and approximately one-third were resistant to amoxicillin/clavulinic acid. In addition, approximately one-quarter of these strains were resistant to cefuroxime [3]. A local study at our institution evaluated the role of renal ultrasound in children with a discharge diagnosis of UTI.…”

The antibiotic susceptibility patterns of uropathogens isolated in Qassim, Saudi Arabia‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬

“…However, our study revealed an overall resistance of 50.4% and E. coli-specific resistance of 49.0% to this antibiotic. Similar results were obtained in a recent study of this nature [21] conducted in the Sultanate of Oman, which revealed an overall resistance of 47% and E. coli-specific resistance of 50% to this antibiotic. This finding is in contrast to reports from European countries of low resistance rates, ranging from 28% to 30% [22,23], and to those from African countries of high resistance rates, ranging from 88.3% to 98.6% [24,25].…”

Differential Markers of Bacterial and Viral Infections in Children for Point-of-Care Testing

“…]. Moreover, antibiotic resistance can negatively affect both individual patient health and public health (and is considered to be one of the biggest global public health challenges) [ 10 ]. Finally, prolonged hospital stays and extended medical treatment for antibiotic-resistant infections may increase the financial burden [ 11.…”