Bacterial Etiologies and Antibiotic Susceptibility Pattern of Urinary Tract Infections at the Pediatric Ward of Dastgheib Hospital, Shiraz, Iran: A Three-Year Study (2009 - 2011)

Abstract

Background: Urinary tract infection (UTI) is one of the most common infections in children. Timely diagnosis and appropriate treatment of UTI requires knowledge of etiologic agents and antibiotic resistance pattern of common uropathogens. Objectives: The aim of this study was to determine bacterial agents and their antibiotic susceptibility patterns at pediatric ward of Dastgheib hospital, Fars province, Shiraz, Iran. Patients and Methods: In this three-year (2009 - 2011) cross-sectional descriptive study, 2854 urine specimens were collected by midstream, urine bag, catheter and suprapubic methods from patients in the age range of 1 month to 14 years. For isolation of uropathogens, samples were cultured on differential and selective media and identified with biochemical tests. Antimicrobial susceptibility testing was then performed using the Kirby Bauer method, following the clinical and laboratory standard institute (CLSI) guidelines. All data were analyzed with the SPSS software (version 15). Results: The most common pathogen was Escherichia coli (65.2%) followed by Staphylococcus saprophyticus (10.9%). Escherichia coli isolates showed the highest and lowest resistance rates to cephalexin (60.5%) and imipenem (11.6%), respectively. Staphylococcus saprophyticus isolates were mostly susceptible to vancomycin (81%), followed by nitrofurantoin (76.8%); however, only 36% of staphylococcus saprophyticus isolates were susceptible to co-trimoxazole. Conclusions: In this study, like previous researches, E. coli was the most common pathogen. Our results suggested a high rate of antibiotic resistance to common antibiotics for treatment of UTI. Because of the high resistance to cephalexin, cefotaxime and co-trimoxazole, their use is not recommended for treatment of UTIs. Imipenem and vancomycin were the most active drugs against E. coli and Staphylococcus saprophyticus, respectively.