Antibiotic Resistance Distribution of Gram-Negative Urinary Tract Infectious Agents: Single Center Experience

Objective: Urinary tract infection (UTI) is one of the most common infections in childhood. The aim of this study was to determine etiologic agents and antimicrobial resistance patterns in urinary tract infections and to evaluate empirical treatment suggestions in a tertiary care hospital. Material and Methods: The culture and antibiogram results of 4,421 urine specimens, sent from Hacettepe University İhsan Doğramacı Children’s Hospital to the microbiology laboratory (between 01.01.2012 and 31.12.2015) were evaluated retrospectively. Results: In 4421 samples where gram-negative (-) growth was detected, Escherichia coli was reported in 64.1%, Klebsiella spp in 17.1% and Proteus spp in 7.4%. Evaluation of all gram-negative microorganisms together, revealed the highest resistance against ampicillin (75.1%), cefazolin (59%), ampicillin-sulbactam (49.7%), trimethoprim-sulfamethoxazole (TMP-SMX) (45.2%), cefixim (33.1%) and ceftriaxone (31.4%). The lowest resistance was against meropenem (3.2%), ertapenem (3.4%), colistin (7.2%), amikacin (16.2%), ciprofloxacin (21.1%) and piperacillin tazobactam (23.2%). Conclusion: In our study, high resistance was detected against ampicillin, ampicillin-sulbactam, first generation cephalosporins and TMP-SMX, commonly used as first-choice treatments in pediatric urinary tract infections. In order to be successful in the treatment and to reduce the morbidity and long-term sequelae, the frequency of pathogenic pathogens and local or regional antibiotic resistance should be known and empirical treatment should be arranged in this direction.