Bacterial Pathogens and Resistance Patterns in Children With Community-Acquired Urinary Tract Infection: A Cross Sectional Study

Background: recent studies on bacterial pathogens causing urinary tract infection (uti) in children have shown high levels of antibiotic resistance in clinical settings. objectives: we determined the common bacterial pathogens causing uti and their antimicrobial resistance patterns in iranian children. patients and methods: the study subjects were 114 children (female subjects, 58.8%) with culture-proven uti categorized in the following 3 age groups: neonates (< 28 days, n = 45), infants (28 days to 2 years, n = 41), and children (> 2 years, n = 28). sensitivity testing was performed using the disc diffusion technique. results: the most frequently cultured pathogens included escherichia coli (71.7%) and enterobacter (28.9%). uti caused by enterobacter was more commonly detected in neonates (60.6%) than in infants (21.2%) and children (18.2%). imipenem was the most active agent against e. coli isolates (susceptibility, 97.3%), followed by ciprofloxacin (90.4%) and amikacin (82.9%). trimethoprim-sulfamethoxazole, cefalotine, and cephalexin were the least active agents, with 76.3%, 75.0%, and 73.7% of e. coli isolates exhibiting resistance, respectively. imipenem and ceftizoxime were the most effective antimicrobial agents against enterobacter, with sensitivity rates of 85.2% and 71.4%, respectively. nitrofurantoin, ceftazidime, and cefalotine were the least active antimicrobial agents against enterobacter, with resistance rates of 92.3%, 66.7%, and 62.5%, respectively. conclusions: the low susceptibility of common uti pathogens to cephalosporins may be because of their high rate of administration to children with uti in our population. a change in empiric therapy should be considered, especially in neonates.