Trends in Antimicrobial Resistance and Demographics of Urinary Tract Infections Regarding Impacts of Urological Comorbidities in Children in a Single Institution Over a 4-Year Period

Objective: This study aims to determine trends in antimicrobial resistance and demographics of urinary tract infections regarding the impacts of urological comorbidities in children. Methods: Data of all children from newborn to age 18 years with culture-proven urinary tract infection between January 1, 2016, and December 31, 2019, were examined through institutional medical records. Samplings and antibiotic susceptibility tests were evaluated according to standard criteria. Results: A total of 931 cases of urinary tract infection from 574 girls (80.70%) and 137 boys (19.30%), being 261 (36.7%) with a predisposing comorbidity for urinary tract infection were enrolled. Vesicoureteral reflux was the leading underlying disorder (5.90%). Escherichia coli, the major prevalent uropathogen (65.00%) was mostly cultured in girls (74.6%); amid non-Escherichia coli isolates in boys. The prevalence of Klebsiella spp. was higher among children with vesicoureteral reflux and in girls with neurogenic bladder. There was no significant trend in antimicrobial resistance rates to Escherichia coli throughout. Resistance rates of Escherichia coli, Klebsiella spp., and the other Enterobacterales to nitrofurantoin, aminoglycosides, and carbapenems were low. Enterococcus spp. and Pseudomonas spp. were mostly susceptible to antibiotics. Conclusion: Escherichia coli is the principal etiological uropathogen causing urinary tract infection in children, and nitrofurantoin, aminoglycosides, or carbapenems emerged as options for empirical treatment.