Uropathogens and antibiotic resistance in the community and hospital-induced urinary tract infected children.

ABSTRACT

OBJECTIVES: In this study, we aimed at identifying community and hospital-induced uropathogens isolated in urinary tract infection (UTI) determining the regional antibiotic resistance and the antibiotic preferences in empirical treatment in Sanliurfa/Turkey. METHODS: The urinary culture results of the 842 paediatric patients, who were aged between 0 and 18 years, admitted to Department of Pediatrics, Harran University Medi-cal Faculty Hospital, Sanliurfa, Turkey with UTI complaints, diagnosed with UTI and in whose urine cultures production was detected, were retrospectively evaluated. Age, gender, clinical findings and culture results of the patients were examined in terms of reproducing pathogens, the frequency of their being community and hospital induced, Extended Spectrum Beta Lactamase production of reproduced pathogens, sensitivity and resistance to antibiotics. RESULTS: A total of 842 patients, 472 (56.1%) girl were included in the study. According to the results of urine culture, Escherichia coli was detected in (58.9%) of the patients, Klebsiella (17.9%) and Proteus (15.8%). While high resistance to ampicillin (87.3%), cefuroxime (71.6%) and trimethoprim-sulfamethoxazole (60.8%) was found for all microorganisms, the lowest resistance to nitrofurantoin (21.4%), piperacillin/tazobactam (19.1), imipenem (8.6%), meropenem (8.8%), amikacin (6.2%) and cefoperazone/sulbactam (CSL) (4.7%) were determined in descending order. Resistance rates were higher in inpatients with UTI than in outpatients. CONCLUSIONS: We think that the most appropriate antibiotic to be chosen for the outpatients for empirical treatment in all age groups in our region, is as oral nitrofurantoin and parenteral amikacin. Also the appropriate parenteral antibiotics that should be selected for the empirical treatment of inpatients UTI in all age groups are the CSL, amikacin and carbapenems.