Antibiotic resistance of Escherichia coli strains in children with urinary tract infections – regional monitoring data

Abstract

Updated information about local antimicrobial susceptibility data is extremely important in prescription of empiric antibacterial therapy.

Aim: dynamic monitoring of local data on the etiological structure of pathogens causing urinary tract infections in children and the level of antibacterial drugs resistance of isolated microorganisms.

Materials and methods: this retrospective study evaluated urine analysis from 550 female and male patients aged 1 month to 18 years with urinary tract infections at the I.N. Grigovich Children’s Republican Hospital in Petrozavodsk, during 2018, 2022, 2023 years.

The results of the study. The study analyzed 301 isolates in 2018, 207 in 2022, 42 in 2023. Enterobacteria were isolated most frequently – 43–71%, of which Escherichia coli – 69–78%, Klebsiella – 14–19%. Escherichia coli resistance to ampicillin has almost doubled by 2022 - from 57% to 88%, p=0.028, in 2023 - 40%. Аmoxicillin/clavulanate - a high level of resistance remains - 2018 and 2022 - 16% and 55%, 2023 - 10% (95% CI, ±11.142). The level of resistance to third- and fourth-generation cephalosporins has almost doubled over 5 years: cefepime from 23% to 42%, in 2023 - 10% (95% CI, ±11.142), cefotaxime from 24% to 39%, in 2023 - 13% (95% CI, ±12.612). The lowest level of resistance throughout all years to meropenem, nitrofurantoin, fosfomycin, amikacin, gentamicin.

Conclusion. The primary local uropathogen is Escherichia coli. Local administration of ampicillin is not permissible in treatment of pediatric urinary tract infections, the use of III-IV generations cephalosporins should be restricted.