A Retrospective Study on Urinary Tract Infection Agents Isolated from Children and Their Antibiotic Susceptibility

Yıl 2020, Cilt: 48 Sayı: 3, 265 - 274, 15.06.2020

Neslihan İdil , Esra Deniz Candan Abbas Yousefi Rad

https://doi.org/10.15671/hjbc.639411

Cited By: 4

Öz

Antibiotics are important premises in the treatment of
urinary tract infection (UTI). However, the use of antibiotics is an important
risk factor causing antibiotic resistance. Antibiotic inappropriate resistance is one of the most important problems of
increased uropathogenic resistance,
especially in pediatric urology. Deficiencies in empirical prescription
practices can make this problem even worse. In this study, the demographic
characteristics of pediatric patients, UTI agents, and antibiotic resistance
resistance of these agents were retrospectively evaluated by an automated
system. The data from 719 UTI agents isolated from children were separately
analyzed for four different age groups (0-2, 2-6, 6-12, and 12-17). The most
commonly isolated infection agents were Escherichia
coli (68.01%), Klebsiella pneumoniae (19.75%), Klebsiella oxytoca (3.34%), Enterobacter cloacae (2.23%), and Pseudomonas aeruginosa
(1.95%). Among the age groups, 0-2 age
group was quite diverse in terms of infection
agents and antibiotic resistance values of these agents were significantly high
in this group (p<0.05). Regarding the antibiotic resistance, the most
noteworthy ones were the resistance against ampicillin (70.2%), amoxicillin-clavulanate (49.0%), cefixime
(38.2%), and trimethoprim/sulfamethoxazole
(37.1%). Our study indicated that
children in 0-2 age group were under
higher risk in terms of UTI agents and their antibiotic resistance but this
risk was reduced with increasing age. Moreover, the ratio of girls with UTI was
greater than that of boys within 0-2 age group. There was high resistance
against cephalosporin, ampicillin, amoxicillin-clavulanate, and trimethoprim/sulfamethoxazole, whereas the resistance
against carbapenem (imipenem, ertapenem and meropenem) was found to be low and
there was no significant increase.

Anahtar Kelimeler

Antibiotic resistance, Escherichia coli, Pediatric urology, Urinary tract infection.

Kaynakça

• 1. R. Quigley, Diagnosis of urinary tract infections in children, Curr. Opin. Pediatr., 21 (2009) 194-198.
• 2. İ. Şahin , Ş. Öksüz, D. Kaya, İ. Şencan, A. Gülcan, Antibiotic susceptibility of uropathogenic gram negative rods isolated from inpatient and outpatient children, ANKEM Derg. 18 (2004) 101–104.
• 3. B. Becknell, M. Schober, L. Korbel, J.D. Spencer, The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections, Expert Rev. Anti. Infect. Ther., 13 (2015) 81-90.
• 4. S. Swerkersson, U. Jodal, C. Åhrén, S. Hansson, Urinary tract infection in small outpatient children: The influence of age and gender on resistance to oral antimicrobials, Eur. J. Pediatr., 173 (2014) 1075-1081.
• 5. P. H.Conway, A.Cnaan, T. Zaoutis, B. V. Henry, R. W. Grundmeier, R. Keren, Recurrent urinary tract infections in children: Risk factors and association with prophylactic antimicrobials, J. Am. Med. Assoc., 298 (2007) 179-186.
• 6. N. Taneja, S. S. Chatterjee, M. Singh, S. Singh, M. Sharma, Pediatric urinary tract infections in a tertiary care center from north India, Indian J. Med. Res. 131 (2010) 101-105.
• 7. S. Habib, Highlights for management of a child with a urinary tract infection. Int. J. Pediatr., (2012).
• 8. N. Shaikh, N. E. Morone, J. E. Bost, M. H. Farrell, Prevalence of urinary tract infection in childhood: A meta-analysis, Pediatr. Infect. Dis. J. 27 (2008) 302-308.
• 9. M. Wennerström, S. Hansson, U. Jodal, E. Stokland, Primary and acquired renal scarring in boys and girls with urinary tract infection, J. Pediatr. 136 (2000) 30-34.
• 10. S. Hellerstein, J. S.Linebarger, Voiding dysfunction in pediatric patients, Clin. Pediatr. (Phila). 42 (2003) 43-49.
• 11. A. M. Sefton, The impact of resistance on the management of urinary tract infections. Int. J. Antimicrob. Agents. 16 (2000) 489–491.
• 12. J. S. Stultz, C. D. Doern, E. Godbout, Antibiotic resistance in pediatric urinary tract infections. Curr. Infect. Dis. Rep. 18 (2016) 1–9.
• 13. Urinary tract infection: Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. American Academy of Pediatrics, 128 (2011) 595-610.
• 14. R. J. Gaspari, E. Dickson, J. Karlowsky, G. Doern, Antibiotic resistance trends in paediatric uropathogens. Int. J. Antimicrob. Agents, 26 (2005) 267-271.
• 15. F. A. Orrett, P. J. Brooks, E. G Richardson, S.Mohammed, Paediatric nosocomial urinary tract infection at a regional hospital, Int. Urol. Nephrol.,31 (1999) 173-179.
• 16. A. Kömürlüoğlu, K. Aykaç, Y. Özsürekçi, S. Tanir Başaranoğlu, A. Biçakçigil, Ü. Liste, B. Altun, B. Sancak, A. B. Cengiz, A. Kara, M. Ceyhan, Antibiotic Resistance Distribution of Gram-Negative Urinary Tract Infectious Agents: Single Center Experience. Turkish J. Pediatr. Dis. (2017) 10–17.
• 17. Y. Topal, Çocuklarda idrar yolu enfeksiyonu: güncel veriler eşliğinde bir değerlendirme. Ortadoğu Tıp Derg., 10 (2018) 26-33.
• 18. R. H.Hanna-Wakim, S.T. Ghanem, M. W. El Helou, S. A. Khafaja, R. A. Shaker et al., Epidemiology and characteristics of urinary tract infections in children and adolescents. Front. Cell. Infect. Microbiol. 26 (2015) 5-45.
• 19. H.F. Shao, W.P. Wang, X.W. Zhang, Z. D. Li., Distribution and resistance trends of pathogens from urinary tract infections and impact on management, ZhonghuaNan Ke Xue 9 (2003) 690-696.
• 20. B. Çoban, N. Ülkü, H. Kaplan, B. Topal, H. Erdoǧan, E. Baskin, Çocuklarda idrar yolu enfeksiyonu etkenleri ve antibiyotik dirençlerinin beş yillik deǧerlendirmesi, Turk Pediatr. Ars.49 (2014) 124-129.
• 21. R. Yılmaz, E. Karaaslan, M. Özçetin, B. Arslan, M. Kilinç, N. Ö. K. Çocuklarda idrar yolları enfeksiyonu etkenleri ve antibiyotik duyarlılıkları Agents of urinary tract infections in children and their antibiotic susceptibility, Journal of Contemporary Medicine, 2 (2012) 17-21.
• 22. C. Konca, M. Tekin, F. Uckardes, S. Akgun, H. Almis, I. H. Bucak, Y. Genc, M.Turgut, Antibacterial resistance patterns of pediatric community-acquired urinary infection: Overview. Pediatr. Int. 59 (2017) 309-315.
• 23. E. Mantadakis, E. K. Vouloumanou, M. Panopoulou, E. Tsouvala, A. Tsalkidis, A. Chatzimichael, M. E. Falagas, Susceptibility patterns of uropathogens identified in hospitalised children with community-acquired urinary tract infections in Thrace, Greece. J. Glob. Antimicrob. Resist., 3 (2015) 85-90.
• 24. I. Alberici, A. K. Bayazit, D. Drozdz, S. Emre, M. Fischbach, J. Harambat, A. Jankauskiene et al., Pathogens causing urinary tract infections in infants: a European overview by the ESCAPE study group. Eur. J. Pediatr., 174 (2015)783-90.