Antibiotic Resistance Patterns in Pediatric Urinary Tract Infections: A Comparison Between 2013-2015 and 2019-2021 Pediatrik İdrar Yolu Enfeksiyonlarında Antibiyotik Direnç Paternleri: 2013-2015 ve 2019-2021 Arasında Bir Karşılaştırma
Abstract
Giriş ve Amaç: İdrar yolu enfeksiyonları (İYE) çocuklarda en sık görülen enfeksiyonlardan biridir. Bu çalışmanın amacı 2013-2015 ve 2019-2021 yılları arasında idrar kültürlerinin etiyoloji ve antibiyotik duyarlılık sonuçlarını değerlendirmek, karşılaştırmak ve yıllar içindeki lokal epidemiyolojik farkı ortaya koymaktır.
Gereç ve Yöntemler: Bu çalışmaya üreme olan 1000 idrar kültürü (2013-2015 ve 2019-2021 dönemleri için 500'er kültür) ve antibiyogram sonuçları dahil edildi.
Bulgular: Her iki yıl aralığında da idrar kültürlerinde en çok saptanan üropatojenler E. coli ve Klebsiella türleri olarak bulundu. E. coli ve Klebsiella türleri ampisilin, amoksisilin, trimetoprim-sulfametoksazol, sefuroksim ve seftriakson'a karşı yüksek direnç göstermiştir. E. coli'nin ampisilin, amoksisilin ve trimetoprim-sulfametoksazole direnç oranları sırasıyla %65, %46 ve %45 olarak bildirilmiş ve 2019-2021 yılları arasında anlamlı olarak artmıştır (sırasıyla p <0,001, p <0,001, p = 0,003). Bu iki çalışma döneminde Klebsiella, Proteus ve Enterococcus türlerinin antibiyotiklere direnç oranlarında anlamlı bir fark saptanmamıştır.
Sonuç: E. coli'ye karşı en sık kullanılan antibiyotikler olan ampisilin, amoksisilin, trimethoprim-sulfametaksazolün en yüksek direnç oranlarına sahip olduğu görüldü. İYE'lerde ampirik antibiyotik önerileri için yerel kılavuzları yeniden düzenlemek amacı ile antibiyotiklerin yerel duyarlılıklarını araştırmak önemlidir.
References
- Simões E Silva, A.C, Oliveira, E.A, Mak, R.H, Urinary tract infection in pediatrics: an overview, Jornal de Pediatria, 2020, 96, Suppl 1:65-79.
- 't Hoen, L.A, Bogaert, G, Radmayr, C, et al., Update of the EAU/ESPU guidelines on urinary tract infections in children, Journal of Pediatric Urology, 2021,17(2), 200-207.
- Becknell, B, Schober, M, Korbel, L, Spencer, J.D, The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections, Expert Review of Anti-Infective Therapy, 2015,13,81–90.
- Dai, B, Jia, J, Mei, C, Long term antibiotics for the prevention of recurrent urinary tract infection in children: a systemic review and meta-analysis, Archives of Disease in Childhood, 2010, 95(7), 499-508.
- Simões e Silva, A.C, Oliveira, E.A, Update on the approach of urinary tract infection in childhood, Jornal de Pediatria, 2015, 91(6 Suppl 1), S2-10.
- Coulthard M.G, Lambert H.J, Vernon S.J, et al., Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: mixed retrospective and prospective audits, Archives of Disease in Childhood, 2014, 99(4), 342-347.
- Awais, M, Rehman, A, Baloch, N.U, et al., Evaluation and management of recurrent urinary tract infections in children: State of the art, Expert Review of Anti-InfectiveTherapy, 2015, 13(2), 209-231.
- NICE. Urinary tract infection in children: diagnosis, treatment and long-term management. CG54. [Clinical guideline]. London: National Institute for Health and Care Excellence; 2007. Available from: http://guidance.nice.org.uk/CG054. (Accessed 01.01.2022).
- Butler, C.C, O'Brien, K, Wootton, M, et al., DUTY Study Team. Empiric antibiotic treatment for urinary tract infection in preschool children: susceptibilities of urine sample isolates, Family Practice, 2016, 33(2), 127-132.
- Delbet, J.D, Lorrot, M, Ulinski, T, An update on new antibiotic prophylaxis and treatment for urinary tract infections in children, Expert Opinion on Pharmacotherapy 2017, 18, 1619–1625.
- Mahony, M, McMullan, B, Brown, J, Kennedy, S.E, Multidrug-resistant organisms in urinary tract infections in children, Pediatric Nephrology, 2020, 35(9), 1563-1573.
- Hodson, E.M, Craig, J.C, Urinary tract infection. In: E.D. Avner (Ed.) Pediatric Nephrology. 7th edn. Philadelphia: Lippincott Williams & Wilkins, 2016, pp. 1695-1715.
- Duicu, C, Cozea, I, Delean, D, Aldea, A.A, Aldea, C, Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania, Experimental and Therapeutic Medicine, 2021;22(1):748.
- Esposito, S, Biasucci, G, Pasini, A, et al., Antibiotic Resistance in Paediatric Febrile Urinary Tract Infections, Journal of Global Antimicrobial Resistance, 2021, S2213-7165(21)00253-8.
- Samancı, S, Çelik, M, Köşker, M, Antibiotic resistance in childhood urinary tract infections: A single-center experience, Turk Pediatri Arsivi, 2020, 55(4):386-392.
- Cag, Y, Haciseyitoglu, D, Ozdemir, A.A, Cag, Y, Antibiotic Resistance and Bacteria in Urinary Tract Infections in Pediatric Patients, Medeniyet Medical Journal, 2021;36(3):217-224.
- Ahmed, M, Long, W.N.W, Javed, S, Reynolds, T, Rising resistance of urinary tract pathogens in children: a cause for concern, Irish Journal of Medical Science, 2022 Feb;191(1):279-282.
- Thaulow, C.M, Lindemann, P.C, Klingenberg, C. Antibiotic resistance in paediatric UTIs in Norway. Tidsskrift for den Norske Legeforening, 2021;141(10).
- İdil, N, Candan, E.D, Rad, A.Y, A Retrospective Study on Urinary Tract Infection Agents Isolated from Children and Their Antibiotic Susceptibility, Hacettepe Journal of Biology and Chemistry, 2020; 48(3): 265-274.
- Ammenti, A, Alberici, I, Brugnara, M, et al., Italian Society of Pediatric Nephrology. Updated Italian recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children, Acta Paediatrica, 2020;109(2):236-247.
- EAU guidelines in paediatric urology. Urinary tract infections in children. Chapter 3.8,2020;30-38. https://uroweb.org/wp-content/uploads/EAU-ESPU-Guidelines-on-Paediatric-Urology-2020.pdf (accessed 10.02.2022).
Antibiotic Resistance Patterns in Pediatric Urinary Tract Infections: A Comparison Between 2013-2015 and 2019-2021
Abstract
Objective: Urinary tract infections (UTIs) are one of the most common infections in children. The aim of this study was to assess and compare the etiology and antibiotic susceptibility results of urine cultures obtained between 2013-2015 and 2019-2021 and evaluate local epidemiologic differences over years.
Materials and Methods: A total of 1,000 samples with positive urine cultures (500 cultures each for the 2013-2015 and 2019-2021 periods) and antibiogram results were included in this study.
Results: The most grown uropathogens were Escherichia coli and Klebsiella spp. in both two periods. E. coli and Klebsiella spp. showed high resistance to ampicillin, amoxicillin, trimethoprim-sulfamethoxazole, cefuroxime, and ceftriaxone. The resistance rates of E. coli to ampicillin, amoxicillin and trimethoprim-sulfamethoxazole were reported as 65%, 46%, and 45%, respectively and significantly increased in 2019-2021 compared to 2013-2015 (p<0.001, p<0.001, and p=0.003, respectively). There was no significant difference in the resistance rates of Klebsiella, Proteus and Enterococcus spp. to antibiotics during the two-study period.
Conclusion: It was observed that the most commonly used antibiotics, ampicillin, amoxicillin, trimethoprim-sulfamethoxazole, against E. coli had the highest resistance rates. It is important to confirm the local susceptibility patterns of antibiotics to revise local guidelines in terms of empirical antibiotic recommendations in UTIs.
References
- Simões E Silva, A.C, Oliveira, E.A, Mak, R.H, Urinary tract infection in pediatrics: an overview, Jornal de Pediatria, 2020, 96, Suppl 1:65-79.
- 't Hoen, L.A, Bogaert, G, Radmayr, C, et al., Update of the EAU/ESPU guidelines on urinary tract infections in children, Journal of Pediatric Urology, 2021,17(2), 200-207.
- Becknell, B, Schober, M, Korbel, L, Spencer, J.D, The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections, Expert Review of Anti-Infective Therapy, 2015,13,81–90.
- Dai, B, Jia, J, Mei, C, Long term antibiotics for the prevention of recurrent urinary tract infection in children: a systemic review and meta-analysis, Archives of Disease in Childhood, 2010, 95(7), 499-508.
- Simões e Silva, A.C, Oliveira, E.A, Update on the approach of urinary tract infection in childhood, Jornal de Pediatria, 2015, 91(6 Suppl 1), S2-10.
- Coulthard M.G, Lambert H.J, Vernon S.J, et al., Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: mixed retrospective and prospective audits, Archives of Disease in Childhood, 2014, 99(4), 342-347.
- Awais, M, Rehman, A, Baloch, N.U, et al., Evaluation and management of recurrent urinary tract infections in children: State of the art, Expert Review of Anti-InfectiveTherapy, 2015, 13(2), 209-231.
- NICE. Urinary tract infection in children: diagnosis, treatment and long-term management. CG54. [Clinical guideline]. London: National Institute for Health and Care Excellence; 2007. Available from: http://guidance.nice.org.uk/CG054. (Accessed 01.01.2022).
- Butler, C.C, O'Brien, K, Wootton, M, et al., DUTY Study Team. Empiric antibiotic treatment for urinary tract infection in preschool children: susceptibilities of urine sample isolates, Family Practice, 2016, 33(2), 127-132.
- Delbet, J.D, Lorrot, M, Ulinski, T, An update on new antibiotic prophylaxis and treatment for urinary tract infections in children, Expert Opinion on Pharmacotherapy 2017, 18, 1619–1625.
- Mahony, M, McMullan, B, Brown, J, Kennedy, S.E, Multidrug-resistant organisms in urinary tract infections in children, Pediatric Nephrology, 2020, 35(9), 1563-1573.
- Hodson, E.M, Craig, J.C, Urinary tract infection. In: E.D. Avner (Ed.) Pediatric Nephrology. 7th edn. Philadelphia: Lippincott Williams & Wilkins, 2016, pp. 1695-1715.
- Duicu, C, Cozea, I, Delean, D, Aldea, A.A, Aldea, C, Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania, Experimental and Therapeutic Medicine, 2021;22(1):748.
- Esposito, S, Biasucci, G, Pasini, A, et al., Antibiotic Resistance in Paediatric Febrile Urinary Tract Infections, Journal of Global Antimicrobial Resistance, 2021, S2213-7165(21)00253-8.
- Samancı, S, Çelik, M, Köşker, M, Antibiotic resistance in childhood urinary tract infections: A single-center experience, Turk Pediatri Arsivi, 2020, 55(4):386-392.
- Cag, Y, Haciseyitoglu, D, Ozdemir, A.A, Cag, Y, Antibiotic Resistance and Bacteria in Urinary Tract Infections in Pediatric Patients, Medeniyet Medical Journal, 2021;36(3):217-224.
- Ahmed, M, Long, W.N.W, Javed, S, Reynolds, T, Rising resistance of urinary tract pathogens in children: a cause for concern, Irish Journal of Medical Science, 2022 Feb;191(1):279-282.
- Thaulow, C.M, Lindemann, P.C, Klingenberg, C. Antibiotic resistance in paediatric UTIs in Norway. Tidsskrift for den Norske Legeforening, 2021;141(10).
- İdil, N, Candan, E.D, Rad, A.Y, A Retrospective Study on Urinary Tract Infection Agents Isolated from Children and Their Antibiotic Susceptibility, Hacettepe Journal of Biology and Chemistry, 2020; 48(3): 265-274.
- Ammenti, A, Alberici, I, Brugnara, M, et al., Italian Society of Pediatric Nephrology. Updated Italian recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children, Acta Paediatrica, 2020;109(2):236-247.
- EAU guidelines in paediatric urology. Urinary tract infections in children. Chapter 3.8,2020;30-38. https://uroweb.org/wp-content/uploads/EAU-ESPU-Guidelines-on-Paediatric-Urology-2020.pdf (accessed 10.02.2022).
Details
| Primary Language | English |
|---|---|
| Subjects | Paediatrics, Clinical Sciences |
| Journal Section | Araştırma Makalesi |
| Authors | |
| Publication Date | September 30, 2022 |
| Published in Issue | Year 2022 Volume: 9 Issue: 3 |
