Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study

Background: Urinary tract infections (UTIs) are among the most common types of infections during childhood. Limited data are available on the prevalence of UTI in children from Romania, with most being available for hospitalized children. For this reason, we conducted a retrospective observational s...

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Main Authors: Constantin Catalin Marc, Maria Daniela Mot, Monica Licker, Delia Muntean, Daniela Teodora Marti, Ana Alexandra Ardelean, Alina Ciceu, Sergiu Adrian Sprintar, Daniela Adriana Oatis, Alin Gabriel Mihu, Tudor Rares Olariu
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Language:English
Published: MDPI AG 2025-07-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/7/723
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author Constantin Catalin Marc
Maria Daniela Mot
Monica Licker
Delia Muntean
Daniela Teodora Marti
Ana Alexandra Ardelean
Alina Ciceu
Sergiu Adrian Sprintar
Daniela Adriana Oatis
Alin Gabriel Mihu
Tudor Rares Olariu
author_facet Constantin Catalin Marc
Maria Daniela Mot
Monica Licker
Delia Muntean
Daniela Teodora Marti
Ana Alexandra Ardelean
Alina Ciceu
Sergiu Adrian Sprintar
Daniela Adriana Oatis
Alin Gabriel Mihu
Tudor Rares Olariu
author_sort Constantin Catalin Marc
collection DOAJ
description Background: Urinary tract infections (UTIs) are among the most common types of infections during childhood. Limited data are available on the prevalence of UTI in children from Romania, with most being available for hospitalized children. For this reason, we conducted a retrospective observational study in consecutive non-hospitalized children to assess the number of positive UTI samples and the antibacterial resistance of causative pathogens. Methods: This study included 7222 consecutive urine cultures collected from children aged 1 to 18 years who are residents of Arad County, Western Romania. Urine samples were analyzed for leukocyturia and cultures for the presence of monomorphic bacteria. Results: The overall number of positive UTI samples was 10.44%. A higher number of positive UTI samples was observed in females when compared to males and in children aged 6–12 and 12 to 18 years when compared to those aged 1–5 years. The antibiotic susceptibility testing of <i>E. coli</i> isolates revealed high sensitivity to most tested antibacterials. Near-complete susceptibility was observed for fosfomycin (99.71%) and nitrofurantoin (96.01%), while high susceptibility rates were also observed for ciprofloxacin (85.43%) and amoxicillin–clavulanic acid (75.05%). In contrast, high resistance was found for ampicillin (62.28% resistant) and trimethoprim–sulfamethoxazole (36.53% resistant). Conclusions: Given the clinical risks associated with UTI in children, our findings underscore the urgent need for the continued monitoring of multidrug-resistant strains. Our study provides important epidemiological and resistance data to guide empirical treatment and strengthen pediatric antimicrobial resistance surveillance. Future studies should focus on different regions and regularly update resistance patterns to keep treatment and prevention strategies aligned with local conditions.
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spelling doaj-art-22f839366a04435bb2f3aa37f0eb31c72025-08-20T03:55:49ZengMDPI AGAntibiotics2079-63822025-07-0114772310.3390/antibiotics14070723Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational StudyConstantin Catalin Marc0Maria Daniela Mot1Monica Licker2Delia Muntean3Daniela Teodora Marti4Ana Alexandra Ardelean5Alina Ciceu6Sergiu Adrian Sprintar7Daniela Adriana Oatis8Alin Gabriel Mihu9Tudor Rares Olariu10Department of General Medicine, Doctoral School, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDepartment of Biology and Life Sciences, Faculty of Medicine, Vasile Goldis Western University of Arad, 310025 Arad, RomaniaMicrobiology Department, Multidisciplinary Research Center of Antimicrobial Resistance, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMicrobiology Department, Multidisciplinary Research Center of Antimicrobial Resistance, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDepartment of Biology and Life Sciences, Faculty of Medicine, Vasile Goldis Western University of Arad, 310025 Arad, RomaniaDiscipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania“Aurel Ardelean” Institute of Life Sciences, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414 Arad, RomaniaCenter for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaCenter for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDepartment of Biology and Life Sciences, Faculty of Medicine, Vasile Goldis Western University of Arad, 310025 Arad, RomaniaDiscipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, RomaniaBackground: Urinary tract infections (UTIs) are among the most common types of infections during childhood. Limited data are available on the prevalence of UTI in children from Romania, with most being available for hospitalized children. For this reason, we conducted a retrospective observational study in consecutive non-hospitalized children to assess the number of positive UTI samples and the antibacterial resistance of causative pathogens. Methods: This study included 7222 consecutive urine cultures collected from children aged 1 to 18 years who are residents of Arad County, Western Romania. Urine samples were analyzed for leukocyturia and cultures for the presence of monomorphic bacteria. Results: The overall number of positive UTI samples was 10.44%. A higher number of positive UTI samples was observed in females when compared to males and in children aged 6–12 and 12 to 18 years when compared to those aged 1–5 years. The antibiotic susceptibility testing of <i>E. coli</i> isolates revealed high sensitivity to most tested antibacterials. Near-complete susceptibility was observed for fosfomycin (99.71%) and nitrofurantoin (96.01%), while high susceptibility rates were also observed for ciprofloxacin (85.43%) and amoxicillin–clavulanic acid (75.05%). In contrast, high resistance was found for ampicillin (62.28% resistant) and trimethoprim–sulfamethoxazole (36.53% resistant). Conclusions: Given the clinical risks associated with UTI in children, our findings underscore the urgent need for the continued monitoring of multidrug-resistant strains. Our study provides important epidemiological and resistance data to guide empirical treatment and strengthen pediatric antimicrobial resistance surveillance. Future studies should focus on different regions and regularly update resistance patterns to keep treatment and prevention strategies aligned with local conditions.https://www.mdpi.com/2079-6382/14/7/723childrenRomaniaurinary tract infectionUTI<i>E. coli</i><i>Escherichia coli</i>
spellingShingle Constantin Catalin Marc
Maria Daniela Mot
Monica Licker
Delia Muntean
Daniela Teodora Marti
Ana Alexandra Ardelean
Alina Ciceu
Sergiu Adrian Sprintar
Daniela Adriana Oatis
Alin Gabriel Mihu
Tudor Rares Olariu
Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study
Antibiotics
children
Romania
urinary tract infection
UTI
<i>E. coli</i>
<i>Escherichia coli</i>
title Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study
title_full Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study
title_fullStr Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study
title_full_unstemmed Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study
title_short Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study
title_sort trends in positive urine culture rates and antimicrobial resistance in non hospitalized children from western romania a retrospective observational study
topic children
Romania
urinary tract infection
UTI
<i>E. coli</i>
<i>Escherichia coli</i>
url https://www.mdpi.com/2079-6382/14/7/723
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