Document Type : original article

Authors

• Alireza Esmaeilpour ¹
• Hamid Reza Goli ²
• Fatemeh Ashrafian ³
• Mona Moshiri ⁴
• Mehrdad Gholami ^{1, 5}

¹ Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

² Department of Microbiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

³ Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.

⁴ Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

⁵ Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.

Abstract

Background: Identifying antibiotic resistance in uropathogenic pathogens is essential to avoid treatment errors and minimize treatment costs. Despite the clinical significance of Urinary tract infections (UTIs) in children, limited data are available on the antimicrobial resistance patterns of the causative pathogens, highlighting the need for continuous surveillance. Our aim was to determine the pattern of drug resistance in strains isolated from children with UTI.
Methods: This retrospective cross-sectional study was conducted from 2021 to 2023 at Bo Ali Sina Hospital in Sari, Iran. A total of 1502 positive urine culture samples from hospitalized children were included. Antimicrobial susceptibility testing was performed using the disk diffusion method, following Clinical and Laboratory Standards Institute (CLSI) guidelines Data analysis was carried out using Statistical Package for the Social Sciences (SPSS) software.
Results: Of the 1502 cases, 68.8% were female. The most frequently isolated pathogen was Escherichia coli (54.8%), followed by Pseudomonas aeruginosa (3.3%) and Klebsiella spp. (3.1%). Among gram-positive bacteria, Staphylococcus epidermidis (9.0%) was the most prevalent. The highest susceptibility rates were observed for amikacin across E. coli, Klebsiella, and Pseudomonas isolates.
Conclusions: Based on local susceptibility patterns, antibiotics such as amikacin, nitrofurantoin, gentamicin, imipenem, ceftazidime, and ceftriaxone may be considered for empirical treatment of complicated UTIs in hospitalized children to improve their care. However, whenever possible, narrow-spectrum antibiotics should be prioritized. Appropriate antibiotic selection must rely on microbial identification and resistance profiling.

Keywords

• Antibiotic resistance
• Urinary tract infection
• Uropathogenic bacteria