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Introduction: Urinary tract infection (UTI) is among the common bacterial infections in pediatric patients. These infections are more common in girls over one year old. This study aimed to investigate the bacterial distribution and drug resistance status in urine cultures of pediatric patients in our center. Materials and Methods: Urine culture results of patients who were presented to the outpatient clinics or were admitted to the Sivas Cumhuriyet University hospital between January 2017 and December 2022 were included in the study. The hospital automation system, patient files, and laboratory information management system were examined retrospectively. Statistical analysis was performed using the SPSS 22.0 software. A P-value of <0.05 was deemed significant. Results: Significant growth was observed in the urine cultures of a total of 1287 pediatric patients, 889 (69.1%) girls and 398 boys (30.9%). The patients included in the study were between the ages of 0-17, and children aged 1-6 (37.6%) were diagnosed with UTI more frequently than other ages. The most common UTI agent in the pediatric age group was Escherichia coli (56.6%). The first agent isolated in girls and boys is E.coli. Additionally, the prevalence of K. pneumoniae, P. mirabilis and K. oxytoca bacteria was higher in boys (p < 0.05). E. coli isolates showed minimal resistance to such as amikacin (0.6%), fosfomycin (1.0%), nitrofurantoin (1.4%), ertapenem (2.4%), imipenem (0.7%) and meropenem (0.9%). Conclusion: In this study, low resistance levels were detected for amikacin, fosfomycin, nitrofurantoin and carbapenem group antibiotics, which are important alternatives in the empirical treatment of UTI. On the other hand, due to the high resistance levels detected, it is thought that more caution should be exercised in the empirical use of amoxicillin-clavulanate, trimethoprimsulfamethoxazole and cefixime. If these antibiotics are to be preferred, waiting for the antibiogram results is an appropriate approach. [ABSTRACT FROM AUTHOR]

Sonuç: Amerikan Enfeksiyon Hastalıkları Derneği [Infectious Diseases Society of America (IDSA)] rehberinde ÜSE tedavisinde ilk seçenek olarak trimetoprim/sulfametoksazol, alternatif olarak da kinolonlar tavsiye edilmektedir. Ayrıca uluslararası tedavi rehberleri, komplikasyonsuz alt ÜSE'lerin ampirik tedavisinde direnç oranları %20'den yüksek antimikrobiyallerin kullanımını önermemektedir. Çalışmamızda; levofloksasin, siprofloksasin ve norfloksasin direnç oranları birbirine yakın olup ampirik tedavi için uygun görünmektedir, ancak trimetoprim/sulfametoksazol direnç oranı yüksek göörülmüştür (%36,3). Toplum kökenli hasta idrar örneklerinden beş yıllık sürede izole edilen E. coli izolatlarında saptadığımız %26,1'lik GSBL (genişlemiş spektrumlu ß-laktamaz) oranıyla birlikte, direnç oranları yüksek ampisilin, amoksisilin, amoksisilin/klavulanat, trimetoprim/sulfametoksazol ve sefalosporinlerin ampirik tedavi için uygun olmadığını düşünmekteyiz. Çalışmamızdaki sonuçlara dayanarak fosfomisinin tek doz oral kullanım avantajı, yüksek hasta uyumu ve düşük yan etki profili ile ayaktan hastalarda ampirik tedavi için ilk seçilecek ilaç olduğunu ve özellikle nonkomplike ÜSE'lerin ampirik tedavisinde nitrofurantoinin alternatif olduğunu düşünmekteyiz. Objective: Escherichia coli (E. coli) is the most common pathogen of bacterial infections worldwide and is responsible for 80% of urinary tract infections (UTIs). In recent years, resistance to antimicrobials used in the treatment of infections caused by E. coli has been increasing all over the world, and it is necessary to constantly monitor resistance rates and update empirical treatment recommendations in order to prevent treatment failure and increase in treatment costs. Methods: In this study, antimicrobial resistance rates of E. coli strains grown in urine culture samples sent from all polyclinics to Malatya Training and Research Hospital Microbiology laboratory between 2015-2019 were retrospectively investigated. Conventional methods and Vitek 2 Compact automated system (BioMérieux, France) were used for the identification of bacteria in plaques with significant growth and for antimicrobial susceptibility testing (AST). AST results were determined as sensitive and resistant according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Results: It was detected significant growth in 14.8% (22636/153006) of urine cultures of outpatients over a five-year period, and identification and ASTs were studied. E. coli constituted 68.3% (15475/22636) of the identified factors. The antimicrobial drugs with the highest resistance rates were ampicillin (65.2%), amoxicillin/clavulanate (38.5%), trimethoprim/sulfamethoxazole (36.3%), cephalexin (35%) and cefuroxime (31.3%) respectively. The least resistance rates were found against carbapenems (0.6-2.1%), fosfomycin (3.6%), nitrofurantoin (5.8%) and amikacin (7.5%), respectively. Quinolone resistance rates were found to be 16.7% for levofloxacin, 19.1% for ciprofloxacin and 21.9% for norfloxacin. Conclusion: In the guideline of the Infectious Diseases Society of America (IDSA), trimethoprim/sulfamethoxazole is recommended as the first choice in the treatment of UTI, and quinolones are recommended as an alternative. In addition, international treatment guidelines do not recommend the use of antimicrobials with resistance rates higher than 20% in the empirical treatment of uncomplicated lower UTIs. In our study, the resistance rates of levofloxacin, ciprofloxacin and norfloxacin were close to each other and seemed appropriate for empirical treatment, but the rate of trimethoprim/sulfamethoxazole resistance was high (36.3%). It is thought think that ampicillin, amoxicillin, amoxicillin/clavulanate, trimethoprim/sulfamethoxazole and cephalosporins with high resistance rates are not suitable for empirical treatment, with an ESBL (extended spectrum ß-lactamase) rate of 26.1% in E. coli isolates isolated from community-acquired patient urine samples over a five-year period. Based on the results of our study, it is thought that fosfomycin is the first drug of choice for empirical treatment in outpatients with its advantage of single-dose oral use, high patient compliance and low side-effect profile, and nitrofurantoin is an alternative especially in the empirical treatment of non-complicated UTIs. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to investigate the antimicrobial susceptibilities of Escherichia coli isolated from urinary cultures in Central Laboratory of Hacettepe University Faculty of Medicine Hospital and to examine the differences between antimicrobial susceptibilities of E. coli isolated from different patient groups. Methods: E. coli isolated from urinary cultures between January 1, 2017 and April 30, 2018 were included in our study. Automated systems, i.e. VITEK® 2 Compact (bioMérieux, Marcy l'Etoile, France) and BD Phoenix (Becton Dickinson, Sparks, MD, USA) and disk diffusion test were used for the determination of antimicrobial susceptibilities. The patients from whom the bacteria were isolated were divided into groups according to age (<18 years, 18-64 years, and >64 years), gender and patient care (outpatients/inpatients). Results: The highest susceptibility rates were observed for carbapenems (>99%), fosfomycin (98.5%), nitrofurantoin (98.3%) and amikacin (94.2%), whereas the highest resistance rates were observed for ampicillin (61.3%) and amoxicillin--clavulanate (37.5-45.7%). Antimicrobial resistance rates of isolates from patients aged 65 years and over were higher than those of patients in other age groups, with the exception of piperacillintazobactam, amikacin and ertapenem. The resistance rates of isolates belonging to male patients were higher than those belonging to female patients for all antimicrobials. Also, the resistance rates of isolates belonging to inpatients were higher than those belonging to outpatients for all antimicrobials. When the rates of extended-spectrum-lactamase (ESBL)-producing E. coli from different age groups were compared, the highest rate (34.2%) was observed among the isolates from patients aged 65 years and over. The rates of ESBL-producing E. coli from males (33.9%) and inpatients (36.3%) were higher than those from females (23.8%) and outpatients (23.3%), respectively. Conclusions: Antimicrobial susceptibilities of E. coli isolates may vary among different patient groups. Demographic features of patients may guide for selecting the antimicrobials for empiric treatment of urinary tract infections. [ABSTRACT FROM AUTHOR]

Objective: Production of extended-spectrum β-lactamases (ESBLs) is the most important antimicrobial resistance mechanism among Gram-negative pathogens. In this study, ESBL frequency and antimicrobial resistance of Escherichia coli and Klebsiella spp. isolated from community-acquired urinary tract infections (UTIs) are investigated. Methods: In this retrospective cross-sectional study, ESBL rates and the results of antimicrobial susceptibility tests were determined for E. coli and Klebsiella spp. grown in the urine cultures of 520 patients with community-acquired UTI, and the changes in the antimicrobial resistance rates of the isolates were compared in terms of ESBL production. Results: E. coli had grown in 220 samples and Klebsiella spp. in 38 samples. ESBL production frequencies of the isolates were found as 40% and 47.4%, respectively, and the rate of carbapenem resistance was found as 3.1%. Among the isolates, the highest resistance was found for amoxicillin-clavulanate (46%), ciprofloxacin (44.9%), and ceftriaxone (42.2%), while the lowest resistance was found for colistin (0.3%), fosfomycin (1.5%), amikacin (3.1%), and nitrofurantoin (4.2%). In ESBL-producers, significantly higher resistance was found for all antibiotics studied, except colistin, nitrofurantoin and fosfomycin. Conclusions: In this study, it was shown that almost half of the community-acquired isolates were ESBL-producers, and these isolates had acquired resistance against many antimicrobials including the last resorts such as carbapenems and colistin. To reduce the progress of resistance rates in E. coli and Klebsiella spp. which are the most common pathogens in community-acquired UTIs, their therapies should be planned according to the results of susceptibility tests as much as possible. [ABSTRACT FROM AUTHOR]

Objective: Urinary Tract Infections (UTI) are most common causes of bacterial infections in humans. Escherichia coli (E.coli) is the most frequently isolated microorganism in cases of uncomplicated UTI. In this study, we aimed to determine antimicrobial resistance patterns of E.coli strains isolated from patients with UTI. Materials and Methods: E.coli strains isolated from urine cultures of patients admitted to the Hospital of the Medical Faculty of Bezmialem Vakif University were retrospectively evaluated between the dates of January 2013 and December 2013. The bacterial identification and rates of antibiotic resistance were determined using VITEK-2 automatized system. Results: E.coli isolates were found to have low resistance rates to fosfomycin (0.6%), nitrofurantoin (5.3%) and amikacin (8%). Among the other antibiotics, the lowest susceptibility rates were detected to ampicillin (64%), trimetoprim/sulfomethoxazole (43.2%), amoxicillin/clavulonic acid (32.8%). Conclusion: Fosfomisin, nitrofurantoin and amikacin are thought to be suitable antimicrobial agens in the empiric treatment treatment of uncomplicated UTI. [ABSTRACT FROM AUTHOR]