Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania

Duicu,Carmen; Cozea,Iulia; Delean,Dan; Aldea,Andreea Alexandra; Aldea,Cornel

doi:10.3892/etm.2021.10180

Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania

Authors:
- Carmen Duicu
- Iulia Cozea
- Dan Delean
- Andreea Alexandra Aldea
- Cornel Aldea
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Affiliations: Department of Pediatrics, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540142 Târgu Mureş, Romania, Pediatric Clinic 1, Emergency County Hospital, 540139 Târgu Mureş, Romania, Pediatric Nephrology Department, Emergency Clinical Hospital for Children, 400124 Cluj‑Napoca, Romania, Neurology Clinic, Clinical Recovery Hospital Cluj‑Napoca, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400347 Cluj‑Napoca, Romania
Published online on: May 12, 2021 https://doi.org/10.3892/etm.2021.10180
Article Number: 748

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Abstract

One of the most frequent bacterial infections in children are urinary tract infections (UTIs). In recent years, an increasing incidence of UTIs caused by resistant bacterial strains has been observed, especially with extended‑spectrum β‑lactamase‑producing Enterobacteriaceae that represent about 15% of UTIs. A retrospective study was performed comprising 331 pediatric cases with UTI. Our study aimed to detect the resistance of the uropathogens to common drugs used in UTI treatment. High resistance rates have been recorded for ampicillin, amoxicillin, trimethoprim/sulfamethoxazole (TMP/SMX), cefuroxime, and ciprofloxacin, among E. coli and Klebsiella. The multidrug‑resistance (MDR) rate was detected in one‑third of the uropathogens, among which more than half were isolated in patients with urinary tract abnormalities. Our study highlighted that nitrofurantoin, ceftriaxone, amikacin and carbapenem may be used for the empirical treatment for febrile or complicated UTI in children. This is the first comprehensive study that evaluates antibiotic resistance in UTIs in children, and their association with urinary tract abnormalities in Romania. As a result of this research, the protocol for initial empiric treatment of infants with febrile or complicated UTI should be modified considering a detailed and ongoing monitoring of local sensitivity of uropathogens to antimicrobial agents.

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