Do the resistance patterns of bacterial uropathogens change over the years in children?

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Şafak İ. N., Kavaz Tufan A., Çetin N., Kılıç Ö., Durmaz G.

53rd Annual Meeting of European Society for Paediatric Nephrology, Amsterdam, Netherlands, 16 - 19 September 2021, pp.3487-3488

  • Publication Type: Conference Paper / Summary Text
  • City: Amsterdam
  • Country: Netherlands
  • Page Numbers: pp.3487-3488
  • Eskisehir Osmangazi University Affiliated: Yes


EP-324 DO THE RESISTANCE PATTERNS OF BACTERIAL UROPATHOGENS CHANGE OVER THE YEARS IN CHILDREN? İkbal Nur Şafak 1 , Asli Kavaz Tufan 2 , Nuran Çetİn 2 , Ömer Kiliç 3 , Gül Durmaz 4 1 Eskisehir Osmangazi University, Faculty Of Medicine, Department Of Pediatrics 2 Eskisehir Osmangazi University, Faculty Of Medicine, Department Of Pediatric Nephrology 3 Eskisehir Osmangazi University, Faculty Of Medicine,department Of Pediatric Infectious Disease 4 Eskisehir Osmangazi University, Faculty Of Medicine, Department Of Microbiology Pediatr Nephrol (2021) 36:3285–3491 3487 Introduction: Urinary tract infections are among the most common infections of childhood and the development of resistance to antibiotics causes treatment failure. Therefore, the aim of this study is to evaluate the resistance patterns of uropathogens by years and to find risk factors affecting the development of antibiotic resistance. Material and methods: This study retrospectively assessed 1852 patients (1308 females) between 1 month and 18 years of age with a diagnosis of urinary tract infection and 2340 urine cultures of these patients with uropathogen growth above 105 CFU/mL from January 2010 to December 2019. Results: The mean age was 73 ± 61 months (1-215 months) and the number of urinary tract infection episodes was 2.5±3.8 (1-39). Urinary tract anomalies were found in 15.7% of the patients, among which hydronephrosis (8.8%) was the most common. The most common uropathogens in urine culture were respectively E.coli (59.6%) Klebsiella spp. (11.5%) and Enterococcus spp. (9.5%). There was a statistically significant increase in the growth rate of E.coli, Klebsiella pneumoniae and Acinetobacter spp. by years (p <0.001). The frequency of ESBL positive uropathogens was 16.2% at ten-year follow-up. ESBL positivity was higher in infants, patients with recurrent UTIs, urinary anomalies, and those who had used prophylactic antibiotics (p<0.05). Antibiotics with the highest resistance were penicillin (60.8%), ampicillin (55.7%) and trimethoprim-sulfamethoxazole (40.8%). While there was no increase in resistance to carbapenems in ESBL positive E.coli, it was found that imipenem and meropenem resistance increased in Klebsiella strains (p <0.05). Conclusions: In the treatment of UTI, especially in infants younger than 12 months, and those with urinary anomalies and a history of recurrent UTIs, appropriate antibiotic should be chosen in accordance with local studies.