A Nine-Year Follow-Up of Antimicrobial Resistance Profile in Children with Urinary Tract Infection in Northern Iran

Background and Objective: Urinary tract infection (UTI) is one of the most common infections in children. Arbitrary use of antibiotics has increased the resistant strains and transmits these resistant factors to other pathogens. Therefore, this study was designed to follow the resistance trend in ۹-years in children with urinary tract infections referred to the Amirkola Children's hospital (Northern Iran). Materials and Methods: In this cross-sectional study, all children who had Urinary tract infections between ۱۹۹۴ to۱۹۹۸ and ۲۰۱۳ to ۲۰۱۸ with one month to ۱۸ years old were included. Data (covering ۹ years), such as age, sex, antibiotic resistance profile, urine culture results, and history of UTI, were collected retrospectively from patients' records. Cases were selected based on clinical and microbiological criteria. Antimicrobial susceptibility was determined by the Kirby–Bauer disk diffusion method. Results: Escherichia coli was the most predominant organism isolated from urine samples. The highest drug resistance was related to cefazolin (۸۳.۳%). Resistance to nitrofurantoin was higher in children older than ۵ years (P≤۰.۰۰۱). Moreover, the resistance pattern to gentamicin, amikacin, ceftriaxone, cephalexin, and imipenem differed in females and males (P>۰.۰۵). Conclusion: A ۹-year study showed that ۹۱.۴% of the strains are still sensitive against amikacin which is a suitable treatment option in the studied strains. The establishment of antimicrobial stewardship programs and regular monitoring of antimicrobial resistance could help to reduce inappropriate prescribing for UTIs.

Keywords:

Antibiotic resistance , Children , Iran , Urinary tract infection , مقاومت آنتی بیوتیکی , عفونت مجاری ادراری , کودکان , ایران