Antibiotic Resistance Profile of Pathogen Escherichia Coli in Children with Urinary Tract Infection

Background: Urinary tract infection (UTI) in children is a serious condition that should be treated promptly and properly to prevent further complications. The most common causative agent of UTI is Escherichia coli (E.coli). This study aims to investigate the resistance profile of E.coli in pediatric cases of UTI. Method: In this cross-sectional study, the positive cultures for E.coli in patients admitted in Dr. Sheikh Children Hospital of Mashhad, Iran, in Feb ۲۰۲۰ to Feb ۲۰۲۱ were assessed. The demographic factors including age and sex were excluded. Urinalysis was conducted to assess the number of bacteria (categorized as mild, moderate, and many) and the WBC count (categorized as > ۵/hpf, > ۱۰/hpf, and > ۱۵/hpf). Furthermore, the antibiogram was consulted to assess the sensitivity and resistance to different antibiotics. Data was analyzed using SPSS software. Results: In ۱۶۰ children (۲۰ males and ۱۴۰ females) with the mean age of ۲۴.۰۰ ± ۲۶.۰۶ months, urinalysis showed that ۲۲.۵% were in the mild bacteriuria category, ۲۱.۳% in moderate bacteriuria, and ۵۶.۳% in the many bacteriuria category. For WBC count in urine, ۱۲.۵% had more than ۵/hpf WBC, ۱۱.۹% had more than ۱۰/hpf WBC, and ۷۵.۶% more than ۱۵/hpf WBC. Regarding resistance, ۴.۵% of the patients were resistant to Amikacin, ۶.۵% to Nitrofurantoin, ۲۰% to Ofloxacin, ۳۵.۱% to Ciprofloxacin, ۵۰% to Gentamicin, ۵۲.۶% to Cefixime, ۵۹.۵% to Cefazolin, and ۷۶.۱% to Trimethoprim. The mean age and also the frequency of sex showed no significant difference between different severities of bacteriuria and WBC count in urine analysis (P > ۰.۰۵). Conclusion: The highest E.coli resistance was to Trimethoprim, Cefazolin, Cefixime, Gentamicin, and Ciprofloxacin. The lowest resistance was to aAmikacin and Nitrofurantoin.

Keywords:

E. coli , Resistance , Antibiogram , Children , Urinary tract infection