Clinico-bacteriological Profile, Antibiotic Resistance Pattern, in Recurrent Urinary Tract Infections In Children

Background: Urinary tract infections (UTIs) are among the significant health concerns in children. In addition, recurrent UTIs pose a greater challenge with increasing rates of antibiotic resistance and acute kidney injury.  Objectives: To study the clinical and bacterial profiles, resistance patterns, and associated risk factors for recurrent UTIs in the pediatric population.  Methods: A prospective observational study over ۱۸ months was conducted, during which ۶۰ children aged ۱ month to ۱۸ years with recurrent UTIs were enrolled. Data on demographics, clinical presentation, underlying anomalies, bacterial isolates, and antibiotic susceptibility (antibiogram) and imaging results were recorded and analysed.  Results: Of ۶۰ patients, ۳۵(۵۸.۳%) were female, and the mean age of the studied children was ۴.۸۸±۳.۹۹ years. The most common symptoms were fever in ۴۲ patients (۷۰%), abdominal pain in ۴۰(۶۶.۷%), and dysuria in ۲۵(۴۱.۷%). Congenital anomalies of the kidney and urinary tract (CAKUT) were present in ۴۳ patients (۷۱.۷%), with vesicoureteral reflux in ۲۷(۴۵%) being the most prevalent. Bowel bladder dysfunction (BBD) was seen in ۳۹(۶۵%) enrolled patients. Urine culture grew gram-negative microorganisms in ۴۶(۷۶.۷%); Escherichia coli was the most common, showing ۱۰۰% sensitivity to nitrofurantoin and colistin but ۱۰۰% resistance to ampicillin and cefotaxime. Gram-positive enterococci were isolated from ۱۰/۶۰ (۱۶.۶%) and showed ۱۰۰% sensitivity to nitrofurantoin, vancomycin, and linezolid; however, they were ۱۰۰% resistant to gentamicin.  Conclusions: Children with underlying CAKUT and bowel dysfunction are predisposed to recurrent UTIs. E. coli and Enterococci are the most common uropathogens with concerning antibiotic resistance profiles. These findings highlight the need for targeted antibiotic stewardship and early management of BBD and CAKUT to prevent recurrence.

کلیدواژه ها:

Bacteria ، Children ، Infection ، Resistance ، Urinary tract