Etiology and Antibiotic Susceptibility Patterns of Urinary Tract Infections in Children in A General Hospital in Kuwait: A 5-Year Retrospective Study.

OBJECTIVE: The purpose was to determine the bacterial profile and prevalence of antibiotic resistance patterns of uropathogens, as well as evaluate the problem with extended-spectrum β-lactamases (ESBLs) producing isolates, causing urinary tract infections (UTIs) in children in Al-Amiri Hospital, Kuwait, over a 5-year period.

MATERIALS AND METHODS: Significant isolates from symptomatic pediatric patients with UTIs from January 2017 to December 2021 were identified by conventional methods and the VITEK 2 identification card system. Antimicrobial susceptibility testing was performed by disk diffusion method for Gram-positive organisms and an automated VITEK 2 system for Gram-negative organisms. ESBL-producing Enterobacterales was detected by double-disk diffusion method and VITEK-2 system.

RESULTS: Significant bacteriuria was detected in (1342; 13.7%) of the 9,742 urine samples. Escherichia coli accounted for (903; 67.3%) followed by Klebsiella pneumoniae (119; 8.9%), Proteus spp. (77; 5.7%) and Enterococcus spp. (98; 7.4%), respectively. High resistance rates were observed among the Enterobacterales against ampicillin, cephalothin, nitrofurantoin, amoxicillin/clavulanic acid and trimethoprim-sulfamethoxazole. The prevalence of ESBL-producing E. coli and K. pneumoniae was 26% and 55%, respectively. The most sensitive among the tested antibiotics for Gram negative organisms were meropenem, amikacin, gentamycin and piperacillin/ tazobactam and for Gram-positive organisms were vancomycin, ampicillin, linezolid and nitrofurantoin.

CONCLUSION: E. coli remains the most common uropathogen. A high percentage of the uropathogens causing UTI in children was highly resistant to the first- and second-line antibiotics for the therapy of UTI. ESBL-producing bacteria are highly prevalent in children in our hospital. Local antibiograms should be used to assist with empirical UTI treatment.