Investigation of microorganisms reproduced in urine cultures and antibiotic resistance of pediatric patients diagnosed with urinary tract infection in Gaziantep region

Urinary tract infection is the most common infectious disease in childhood after upper respiratory tract infections. It is thought that unconscious antibiotic use in treatment and long-term prophylaxis may be associated with the development of resistance. With early diagnosis and effective treatment, irreversible kidney damage and development of chronic kidney failure can be prevented. In this study, we aimed to investigate the microorganisms reproduced in urinary tract infections and their antibiotic resistance in Gaziantep region. In our study, patients who were diagnosed with urinary tract infection in Gaziantep University Şahinbey Training and Research Hospital Pediatric Nephrology, General Pediatric Polyclinics and Pediatric Emergency departments between January 2016 and December 2020 and whose urine cultures showed significant growth and whose antibiogram were studied were evaluated retrospectively. Epidemiological and clinical data, urinary system imaging results, urine culture and antibiogram results of a total of 1053 patients were reviewed. Statistical Package for Social Sciences (SPSS) 22.0 package analysis program was used to organize the data. The mean age of the cases was 5.43±4.61 years. 75.1% of the patients were female and 24.9% were male. The most common complaints at presentation were abdominal pain with a rate of 27.3% and fever with a rate of 26.5%. It was observed that 88.4% (n=931) of the patients did not use any prophylactic antibiotics, and 11.6% (n=122) used them. Of the patients who underwent imaging, 44.7% (n=335) had pathology on USG, 52.8% (n=220) had scarring on DMSA scintigraphy, and 38.5% (n=99) had reflux on VCUG. detected. E. Coli (74%), Klebsiella (17%), Proteus (7%) and P. aeruginosa (2%) were detected in urine cultures . The most common resistance rates in all patients were 81.6% for ampicillin, 64.3% for cefuroxime, 61.3% for cefixime, 55.9% for ceftriaxone, 55.1% for amoxicillin-clavulanate, 50,7% for trimethoprim-sulfamethoxazole. In patients with first UTI who received prophylaxis, Klebsiella spp. reproduction rates (32.4%) were higher than those who did not receive prophylaxis (14.5%), while Escherichia coli reproduction rates were found to be significantly higher in those who did not receive prophylaxis (77.5%) than those who received prophylaxis (44.1%). Escherichia coli was found to be the most common in those with recurrent UTIs, and no significant difference was found between the two groups in terms of the microorganism percentages that reproduced. The resistance to imipenem (17.6%), colistin (10.3%) and meropenem (11.8%) was found to be significantly higher in those who had first UTI and received prophylaxis compared to those who did not receive prophylaxis. In those with recurrent UTI, resistance to cefepime (73.5%) was significantly higher in those who did not receive prophylaxis compared to those who received prophylaxis. There was no difference in resistance between the groups that received and did not receive prophylaxis against other antibiotics. In conclusion, larger prospective studies are needed to confirm the data obtained from our study. Keywords: Urinary tract infection, antibiotic resistance, prophylaxis