Urinary Tract Infections in Pediatric Age: A5‑Year Hospital‑Based Retrospective Study

Abstract

Introduction: Urinary tract infections are the second most common bacterial infections in pediatric patients. Understanding local antibiotic resistance patterns is essential for appropriate therapeutic decision- making. This study aims to determine the prevalence and antibiotic susceptibility profile of microorganisms responsible for urinary tract infections in a Level II Hospital, to enhance empirical antibiotic prescription and prevent resistance.

Methods: A retrospective and descriptive study was conducted by reviewing the medical records of patients aged 0- 17 years diagnosed with urinary tract infections, confirmed by urinary sediment with >5 leukocytes/field and microorganism identification in urine culture, between 2018 and 2022 in the Pediatric Department. Patients with nephro- urological malformations, positive urine cultures with inactive sediment, and asymptomatic bacteriuria were excluded. Urine samples collected using collection bags were also excluded.

Results: A total of 976 patients were included, with a predominance of females observed across all age groups, except during the first year of life, in which males exhibited a higher prevalence. Escherichia coli was the most frequently isolated microorganism across all age groups, with a sensitivity of 97.7% to cefuroxime- axetil and a resistance rate of 28.1% to amoxicillin- clavulanic acid. In the adolescent population, Staphylococcus saprophyticus demonstrated a prevalence similar to that of Escherichia coli. Staphylococcus saprophyticus exhibited nearly 94% sensitivity to amoxicillin- clavulanic acid and intrinsic resistance to fosfomycin.

Conclusion: Escherichia coli remains the primary etiological agent of urinary tract infections, with a prevalence nearly equivalent to that of Staphylococcus saprophyticus in adolescence, findings consistent with the literature. Considering the antimicrobial resistance pattern observed in our institution, empirical therapy should involve cefuroxime axetil until 12 years of age, followed by amoxicillin- clavulanic acid in older patients. Our findings highlight the importance of continuous monitoring of antibiotic susceptibility patterns to optimize empirical urinary tract infections management and reduce future resistance rates.