Antibiotic susceptibility of escherichia coli strains isolates determined as a cause of urinary tract infection in pediatric patients

Abstract

Urinary tract infections (UTIs) are bacterial infections that are most commonly encountered by physicians in all age groups both in the Nasocomial hospital and community acquired hospital. International guidelines are used for the selection of antibiotics. However, it is recommended to adopt the international guidelines into local epidemiological data before using it to select the routine treatment. In this study, it was aimed to determine the antimicrobial susceptibility of Escherichia coli (E.Coli) strains isolated from urinary tract infections in children applied due to urinary system infections and treated accordingly. It was designed to be examined to be raised from 249 children, with sales route design and sale to the pediatric and urinary outpatient clinic between July 1, 2019 and July 1, 2020. 210 patients with n≥105 cfu/ml bacteria. Patients with vesicourethral reflux and neurogenic patients were excluded from the study. At the same time, people who can be displayed in the products that have been in use in the last six months and people who have grown Klebsiella, Proteus mirabilis, Candida and ESBL positive bacteria. 98 cultures included in the study were evaluated The mean age of totally 98 patients including 84 females and 14 males diagnosed with urinary tract infection was 37 (1-192) months. There was a statistically significant difference between each group with respect to age and they were as F:49 month and M: 9 respectively (p<0.001). Amoclavin-claviculinate 33.6%, ampicillin 20.4%, cefuroxime 25.5%, trimethoprimsulfamethoxazole (TMP-SMX) 19.4%, ciprofloxacin 7.1%, ceftriaxone 19.3% by disc diffusion and / or automated system tests in 141 isolated E. coli strains, 6.1% and 11.2% nitrofurantoin resistance rates were determined. ESBL was found positive in 7 (4.96%) of 141 E. coli isolated and these patients were excluded from the study. Recently, antibiotics are given empirically before performing urine culture and antibiograms and this situation causes the problem of resistance to widely preferred antibiotics. Cefixime, ampicillin or trimethoprim-sulfamethoxazole can be used as the first option in empirical treatment of pediatric urinary tract infections. However, urine culture and antibiogram should be performed if possible before antibiotics are given. It should not be ignored that the rates of resistance may change over time according to the frequent preference of antibiotics initiated empirically in that region or country.