Pediatric - specific Antimicrobial Resistance Patterns of Urinary Tract Infections: A Single - Centre Experience from Turkey

Objectives: Antimicrobial resistance of the causative microorganisms of pediatric urinary tract infection (UTI) is a growing problem. The aim of this study is to determine the changing pattern of antibiotic susceptibility in UTIs in an outpatient setting. Methods: We retrospectively reviewed the medical records of pediatric patients with UTI who were followed-up in our center between January-2014 and May-2015. Results: One hundred and seventy-one patients (M/F= 53/118; mean age 56 ± 47.2 months) with UTI were enrolled in this study. A total of 231 urinary pathogens were isolated from UTI episodes. The most common causative agent was Escherichia coli (E. coli) (70.6%) followed by Klebsiella spp. (16.5%), Proteus spp. (6.5%). One point eight percent of E. coli isolates were resistant to amikacin, 17.8% to gentamicin, 60.7% to TMP-SMX, 66,9% to ampicillin, 52.1% to cefixime, 46% to ceftriaxone, 54.6% to cefuroxime and 4.9% to nitrofurantoin. Conclusions: TMP-SMX and nitrofurantoin are poor empirical choices for pediatric patients due high resistance rates and gastrointestinal side effects, respectively. Second and third -generation cephalosporins (cefixime) may not be considered as appropriate empiric antibiotic alternatives anymore given their high resistance rates in the next few years. Physicians who work in the primary health care should be encouraged for the selection of more appropriate antibiotics.