Objective: In order to contribute the empirical treatment of urinary tract infections in children, the antibiotic resistance patterns of uropathogens isolated in one center over a year, and clinical risk factors were evaluated in this study.

Methods: In this single-center study, the positive urine cultures and their antibiotic susceptibilities in a Child Nephrology Outpatient Clinic between March 2018 and March 2019 were evaluated retrospectively. Patient records, demographic data, obtaining method of urine and accompanying urinary tract problems were noted. Antibiotic susceptibility testing results of patients with significant bacteriuria were evaluated. Multidrug resistant (MDR) organisms were described as having resistance to at least three different groups of antimicrobials. Independent clinical risk factors were investigated by logistic regression analysis in infections due to MDR organisms.

Results: The most common two organisms were Escherichia coli (74.3%) and Klebsiella spp. (10.6%). Resistance rates to cefuroxime and trimethoprim-sulfamethoxazole (TMP-SXT) was 40.6% and 44% for E. coli, and 60.8% and 63% for Klebsiella spp. respectively (p<0.05). Extended spectrum β-lactamase (ESBL) positivity rate was 25.6% among all bacterial isolates. MDR isolates were detected in 63.8% of ESBL-positive organisms whereas it was 36.2% in ESBL-negative ones. Male gender rate was 31.9% in infections due to MDR pathogens, and 20.1% in infections with susceptible ones (p<0.05). Neurogenic bladder and male gender were determined as independent risk factors for isolation of MDR pathogens.

Conclusions: It must be taken into consideration that there is a high resistance to cephalosporins and TMP-SXT in the significant bacteriuria of children with accompanying urinary tract disorders. MDR pathogens are an increasing problem in these patients especially in boys.

Klimik Dergisi 2020; 33(1): 77-81.

Cite this article as: Yel S, Pınarbaşı AS, Pınar Sağıroğlu P, Atalay MA, İpekten F, Dursun İ. [Antibiotic resistance pattern in significant bacteriuria: What is the current situation in the Pediatric Nephrology Department?]. Klimik Derg. 2020; 33(1): 77-81. Turkish.