A Single-Center Experience of Antimicrobial Resistance Patterns in Pediatric Urinary Tract Infection

Objective: To assess the prevalence of urinary tract pathogens and their resistance patterns against antimicrobial agents in a single center. Patients and Methods: In children 16 years of age admitted for urinary tract infection (UTI) to the Dr. Sami Ulus Teaching and Training Hospital from January 2004 to December 2008, positive urine cultures were reviewed. Results: A total of 3,485 positive urine cultures were identified, of which 2,379 (68%) were from females and 106 (32%) from males. Their mean age was 63.5 ± 40.7 months. Escherichia coli was the most common causative agent both in total and among different age groups. Ampicillin had the highest resistance rate from all the pathogens isolated (63.8%), followed by piperacillin (51.8%) and trimethoprim-sulfamethoxazole (TMP-SMX; 48.6%). Cephalotin also had a high resistance rate (32.7%). The least resistance was for imipenem, amikacin, netilmicin and ciprofloxacin (0.13, 1.7, 2.4 and 7.5%, respectively). None of the Klebsiella and Pseudomonas isolates were resistant to imipenem. None of the Staphylococcus aureus isolates were resistant to teicoplanin and vancomycin. Vancomycin-resistant Enterococcus spp. were isolated from two cultures. Conclusion:E. coli was the most common causative agent of UTI in children. Ampicillin, TMP-SMX or cephalothin and piperacillin had the highest resistance rates against urinary tract pathogens in our center.