ESPN 50th Annual Meeting

ESPN 2017

The changing pattern of antibiotic resistance in urinary tract infections
Eda Didem Kurt-Sukur 1 Z Birsin Ozcakar 1 Nilgun Cakar 1 Merve Karaman 2 Musa Ozturk 2 Ozlem Dogan 3 Haluk Guriz 3 Fatos Yalcinkaya 1

1- Ankara University School of Medicine, Department of Pediatrics, Division of Pediatric Nephrology
2- Ankara University School of Medicine, Department of Pediatrics
3- Ankara University School of Medicine, Microbiology Laboratory

Urinary tract infection is one of the most common bacterial infections in pediatric age group. The resistance profile of uropathogens is critical in treatment planning. The aim of this study was to assess the resistance patterns of bacteria isolated from urinary tract infections to commonly used antimicrobials and evaluate the options for ampirical treatment.

Material and methods:

A retrospective cross-sectional study was performed in children diagnosed with either lower urinary tract infection or acute pyelonephritis between January 2016 and June 2016. Among 2000 urinary isolates reviewed 460 patients’ culture results were found eligible. Patient demographics  (age, sex), infection site (upper/ lower urinary tract), resistance profile of the urine samples and agent used were noted.


Median age of the patients was 44.5 months (min:0.1, max:208) and male to female ratio was 1/3.8. Acute pyelonephritis episodes were observed in 50.7% of the patients. Previous urinary tract infection history was found in 47.2% of the patients. Prophylaxis was used by 19.1% of the patients. The most common causative agent was E.coli (80.4%) followed by K.pneumonia (8.3%) and 22.8% of the strains were producing extended spectrum beta lactamase. Resistance to ampicilline was found as 66.3%, co-trimexasole 41.4%, amoxicilline-clavulonate 35%, cefotaxime 24.6%, nitrofurantoin 16.1%, gentamycine 11.1% and to ertapenem as 1.3% in all isolates. 


The study revealed that E.coli was the most commonly isolated pathogen in the sample. Extended spectrum beta lactamase producing bacteria is a major problem which constituted the 22.8% of our isolates. Ampiric antibiotic therapy for urinary tract infection should be switched to proper regimen according to the urine culture results. Having regional antibiotic resistance patterns in hand would aid in choosing the right ampiric treatment.