Evaluation of antibiotic resistance pattern of uropathogenic E. coli isolates in children with urinary tract infection hospitalized in Tehran

BACKGROUND AND ABJECTIVEUrinary tract infection (UTI) is common in children and Escherichia coli is its primary pathogen.Although difficult to diagnose in infants and young children, accurate diagnosis and appropriateantimicrobial treatment are crucial to prevent long-term consequences. However, traditionalantibiotics may not be effective due to increasing rates of acquired resistance. This study aimed toexamine the antibiotic resistance pattern in E. coli strains isolated from pediatric UTI patients.MATERIALS AND METHODSBacterial samples were isolated from the pediatric wards at Imam and Loghman hospitals in a periodof ۶ month. Of these, E. coli bacteria were confirmed using biochemical methods and PCR. Antibioticsensitivity, multi-drug resistance (MDR) and extended spectrum beta-lactamase (ESBL) weredetermined using disc diffusion assay, following standard procedures recommended by CLSI.RESULTS AND DISCUSSIONForty E. coli isolates (۲۰ from each hospital) were recovered. The ratio of girls to boys was equal inLoghman Hospital and ۳ to ۱ in Imam Hospital. Most of them were ≤ ۳ years old. The rate ofantibiotic resistance was high in both hospitals while there was no resistance among the isolates tonitrofurantoin. In general, the isolates from Imam Hospital were more resistant than those fromLoghman Hospital. Therefore, the isolates that resistant to a large number of antibiotics (≥۸) weremainly found at Imam Hospital, while those resistant to fewer antibiotics (≤ ۷) were mostly recoveredfrom Loghman Hospital. No isolate in Loghman Hospital was resistant to imipenem, in comparison to۶۰% resistance in Imam Hospital’s isolates. Among the isolates, ۹۵% were MDR, with over a third(۳۷%) being highly resistant to ۱۰ or more antibiotics, while the rest were resistant to ۳ to ۹antibiotics (regular MDR). Again, the ratio of the highly resistant isolates was ۲.۵ times higher atImam Hospital. Meanwhile, ۸۵% of strains were detected as ESBL-producers. More than ۸۰% ofremaining non-ESBL isolates were recovered from Loghman Hospital. The distribution of the isolatesresistant to different number of antibiotics was consistent across all age groups.CONCLUSIONAntibiotic resistance in uropathogenic E. coli is on the rise, affecting even infants and neonates. Thepattern of resistance varies between hospitals and is unrelated to gender or age, but rather specific toeach hospital.

کلیدواژه ها:

Urinary tract infection ، E. coli ، antibiotic resistance ، multidrug resistant ، pediatrics