Retrospective Analysis of Urinary Tract Infection in the Pediatric Population at a Tertiary Care Centre

Abstract

Background: Urinary tract infection (UTI) is among the most common infections occurring during childhood. It is caused by both gram-negative and gram-positive bacteria and Escherichia coli is the most common causative agent. Methods: Data of all pediatric patients in the age group of 6 months to 18 years with urinary tract infection were taken for analysis. Urine samples were collected and cultured on the cystine lactose electrolyte-deficient medium. The presence of bacteria was identified using biochemicals, and the antimicrobial test was performed using the Kirby-Bauer test or the VITEK 2 compact system (bioMérieux, Inc., France). Results: The prevalence of UTI was 23.5%. In total, 614 specimens tested positive with significant bacteriuria. The male-to-female ratio was 1:2.3. Approximately 54% patients presented with urinary symptoms alone. Culture positivity was significantly associated with pyuria (p < 0.0001). E. coli (334/614) was the most common isolate, followed by Enterococcus spp. (92/614). Colistin, polymyxin B, fosfomycin, nitrofurantoin, netilmicin, and amikacin were extremely good acting antimicrobials. Meanwhile, ampicillin, cefotaxime, ceftriaxone, and norfloxacin were highly resistant to gram-negative bacteria. Multidrug-resistant bacteria and extended-spectrum beta-lactamase-producing bacteria were found in 47% and 44.1% of cases, respectively. Vancomycin, linezolid, teicoplanin, and nitrofurantoin were highly effective against gram-positive bacteria. Furthermore, norfloxacin, trimethoprim/sulfamethoxazole, ciprofloxacin, and tetracycline were highly resistant to gram-positive bacteria. Of the 92, 42 Enterococcus spp. were resistant to high-dose gentamicin. Conclusion: Nitrofurantoin and amikacin can be used as empirical therapy for gram-negative and gram-positive bacteria. Because resistance to various commonly used antibiotics is found to be increasing, treatment must be guided by antibiotic susceptibility reports.

Susceptibility to Fosfomycin and Nitrofurantoin of ESBL-Positive Escherichia coli and Klebsiella pneumoniae Isolated From Urine of Pediatric Patients

“…The susceptibility to fosfomycin and nitrofurantoin was 98.5% and 95.2% for E. coli and 96.8% and 75.1% for K. pneumoniae , respectively, in 2022 (including both ESBL-positive and ESBL-negative isolates). 21 The susceptibility of 267 cases of ESBL-producing E. coli to fosfomycin isolated from urine in Korea was 99.6%, followed by ciprofloxacin (68.5%), trimethoprim–sulfamethoxazole (55.4%), and ampicillin (31.5%). 22 However, it is not clear whether pediatric isolates were included in this study.…”

Hybrid Sequencing-Based Genomic Analysis of Klebsiella pneumoniae from Urinary Tract Infections Among Inpatients at a Tertiary Hospital in Beijing

“…5 K. pneumoniae is a significant causative agent of UTI, which can result in high rates of illness and death. 6,7 Due to the high empiric use of antibiotics for the treatment of UTI, the antibiotic resistance of K. pneumoniae increased significantly worldwide. 8 In China, resistance rates to K. pneumoniae UTI isolates have risen for all tested antimicrobials, including carbapenems.…”