Evaluating Antibiotic Resistance in Pediatric UTIs: Five-Year Data from a Tertiary Hospital in Turkey

<i>Background and Objectives</i>: Urinary tract infections (UTIs) are common in children and account for 5–6% of febrile illnesses. This study aims to evaluate the bacterial pathogens isolated from pediatric UTI cases and their antibiotic resistance patterns to inform updated treatment g...

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Main Authors: Fedli Emre Kılıç, Osman Küçükkelepçe
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/3/402
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author Fedli Emre Kılıç
Osman Küçükkelepçe
author_facet Fedli Emre Kılıç
Osman Küçükkelepçe
author_sort Fedli Emre Kılıç
collection DOAJ
description <i>Background and Objectives</i>: Urinary tract infections (UTIs) are common in children and account for 5–6% of febrile illnesses. This study aims to evaluate the bacterial pathogens isolated from pediatric UTI cases and their antibiotic resistance patterns to inform updated treatment guidelines. <i>Materials and Methods</i>: This retrospective study included 2753 children with positive urine cultures treated at Adıyaman Training and Research Hospital from January 2020 to June 2024. Data on patient demographics, bacterial culture results, and antibiotic resistance patterns were analyzed. <i>Results</i>: Among the 2753 patients, 71.1% were female and 28.9% were male, with a mean age of 54.6 ± 48.6 months. <i>Escherichia coli</i> was the predominant pathogen, isolated in 61.2% of cases, followed by <i>Klebsiella pneumoniae</i> (13.3%), <i>Proteus mirabilis</i> (9.1%), and <i>Enterococcus faecalis</i> (3.5%). Gender-specific differences showed that <i>E. coli</i> was more frequently isolated in females (71.7%), while <i>Proteus</i> was more common in males (18.5%). Antibiotic resistance analysis revealed high resistance rates to ampicillin (67.4% in <i>E. coli</i> and 100% in <i>Klebsiella</i>), TMP-SMX (33.2% in <i>E. coli</i> and 30% in <i>Klebsiella</i>), and cefixime (45.3% in <i>E. coli</i>). Amikacin showed the lowest resistance across all pathogens, with only 0.9% resistance in <i>E. coli</i>. The resistance to third-generation cephalosporins, particularly ceftriaxone and cefixime, has significantly increased over time, especially in the <i>Klebsiella</i> species. <i>Conclusions</i>: The results indicate high resistance to ampicillin and TMP-SMX. However, <i>E. coli</i> and other pathogens remain susceptible to nitrofurantoin, amikacin, and carbapenems, making these antibiotics viable for empirical therapy. Regional resistance should be considered when selecting treatments for pediatric UTIs to improve outcomes and reduce resistance development.
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spelling doaj-art-9f26e98c500440e49ef19ff1b0fcaf202025-08-20T02:11:15ZengMDPI AGMedicina1010-660X1648-91442025-02-0161340210.3390/medicina61030402Evaluating Antibiotic Resistance in Pediatric UTIs: Five-Year Data from a Tertiary Hospital in TurkeyFedli Emre Kılıç0Osman Küçükkelepçe1Training and Research Hospital, Department of Pediatrics, Faculty of Medicine, Adıyaman University, Adıyaman 02040, TurkeyAdiyaman Provincial Health Directorate, Adıyaman 02100, Turkey<i>Background and Objectives</i>: Urinary tract infections (UTIs) are common in children and account for 5–6% of febrile illnesses. This study aims to evaluate the bacterial pathogens isolated from pediatric UTI cases and their antibiotic resistance patterns to inform updated treatment guidelines. <i>Materials and Methods</i>: This retrospective study included 2753 children with positive urine cultures treated at Adıyaman Training and Research Hospital from January 2020 to June 2024. Data on patient demographics, bacterial culture results, and antibiotic resistance patterns were analyzed. <i>Results</i>: Among the 2753 patients, 71.1% were female and 28.9% were male, with a mean age of 54.6 ± 48.6 months. <i>Escherichia coli</i> was the predominant pathogen, isolated in 61.2% of cases, followed by <i>Klebsiella pneumoniae</i> (13.3%), <i>Proteus mirabilis</i> (9.1%), and <i>Enterococcus faecalis</i> (3.5%). Gender-specific differences showed that <i>E. coli</i> was more frequently isolated in females (71.7%), while <i>Proteus</i> was more common in males (18.5%). Antibiotic resistance analysis revealed high resistance rates to ampicillin (67.4% in <i>E. coli</i> and 100% in <i>Klebsiella</i>), TMP-SMX (33.2% in <i>E. coli</i> and 30% in <i>Klebsiella</i>), and cefixime (45.3% in <i>E. coli</i>). Amikacin showed the lowest resistance across all pathogens, with only 0.9% resistance in <i>E. coli</i>. The resistance to third-generation cephalosporins, particularly ceftriaxone and cefixime, has significantly increased over time, especially in the <i>Klebsiella</i> species. <i>Conclusions</i>: The results indicate high resistance to ampicillin and TMP-SMX. However, <i>E. coli</i> and other pathogens remain susceptible to nitrofurantoin, amikacin, and carbapenems, making these antibiotics viable for empirical therapy. Regional resistance should be considered when selecting treatments for pediatric UTIs to improve outcomes and reduce resistance development.https://www.mdpi.com/1648-9144/61/3/402empirical treatmentbacterial pathogensantibiotic resistanceurinary tract infection
spellingShingle Fedli Emre Kılıç
Osman Küçükkelepçe
Evaluating Antibiotic Resistance in Pediatric UTIs: Five-Year Data from a Tertiary Hospital in Turkey
Medicina
empirical treatment
bacterial pathogens
antibiotic resistance
urinary tract infection
title Evaluating Antibiotic Resistance in Pediatric UTIs: Five-Year Data from a Tertiary Hospital in Turkey
title_full Evaluating Antibiotic Resistance in Pediatric UTIs: Five-Year Data from a Tertiary Hospital in Turkey
title_fullStr Evaluating Antibiotic Resistance in Pediatric UTIs: Five-Year Data from a Tertiary Hospital in Turkey
title_full_unstemmed Evaluating Antibiotic Resistance in Pediatric UTIs: Five-Year Data from a Tertiary Hospital in Turkey
title_short Evaluating Antibiotic Resistance in Pediatric UTIs: Five-Year Data from a Tertiary Hospital in Turkey
title_sort evaluating antibiotic resistance in pediatric utis five year data from a tertiary hospital in turkey
topic empirical treatment
bacterial pathogens
antibiotic resistance
urinary tract infection
url https://www.mdpi.com/1648-9144/61/3/402
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