Changes in Bacterial Resistance Patterns of Pediatric Urinary Tract Infections and Rationale for Empirical Antibiotic Therapy

Abstract

Background: The causative agent spectrum andresistance patterns of urinary tract infections in childrenare affected by many factors.Aims: To demonstrate antibiotic resistance in urinarytract infections and changing ratio in antibiotic resistanceby years.Study Design: Retrospective cross-sectional study.Methods: We analysed antibiotic resistance patterns ofisolated Gram (-) bacteria during the years 2011-2014(study period 2) in children with urinary tract infections.We compared these findings with data collected in thesame centre in 2001-2003 (study period 1).Results: Four hundred and sixty-five uncomplicatedcommunity-acquired Gram (-) urinary tract infectionswere analysed from 2001-2003 and 400 from 2011-2014. Sixty-one percent of patients were female (1.5girls : 1 boy). The mean age of children included in thestudy was 3 years and 9 months. Escherichia coli wasthe predominant bacteria isolated during both periodsof the study (60% in study period 1 and 73% in studyperiod 2). Bacteria other than E. coli demonstrated ahigher level of resistance to all of the antimicrobialsexcept trimethoprim-sulfamethoxazole than E. colibacteria during the years 2011-2014. In our study, wefound increasing resistance trends of urinary pathogensfor cefixime (from 1% to 15%, p