Antibiotics | Positive Urine Culture Rates and Antimicrobial Resistance Trends in Children with Urinary Tract Infections

This study reviews and summarizes the epidemiological trends of urinary tract infection (UTI) positive samples and analyzes changes in antimicrobial susceptibility and resistance patterns of major pathogens including Escherichia coli and other organisms in non-hospitalized children from Western Romania between 2016 and 2022. It emphasizes the necessity for continuous monitoring of multidrug-resistant (MDR) strains in pediatric populations and provides critical evidence for empirical treatment strategies.

 

Literature Overview
Published in the journal Antibiotics, this retrospective observational study titled 'Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study' examines UTI positivity rates and antimicrobial resistance patterns in children. Based on 7,222 urine samples collected between 2016 and 2022, the study identifies a 10.44% UTI positivity rate, with higher infection rates observed in females and children older than 6 years.

Background Knowledge
Urinary tract infections represent common bacterial infections in pediatric populations, primarily caused by Escherichia coli. Data on UTI prevalence and resistance patterns in non-hospitalized settings, particularly in Romanian regions, remains limited. This study addresses this gap by providing regional resistance trend analysis and informing empirical pediatric treatment strategies. Additionally, it reveals dynamic changes in antimicrobial susceptibility, underscoring the importance of monitoring resistance profiles to optimize therapeutic approaches and support antimicrobial resistance surveillance.

 

 

Research Methods and Experiments
This retrospective observational study analyzed 7,222 urine culture samples from children aged 1-18 years in Arad County, Western Romania. Samples were stratified by age groups (1-5, 6-12, 13-18 years), gender, and urban/rural residence to assess UTI positivity rates. All cultured isolates underwent antimicrobial susceptibility testing to evaluate resistance patterns of E. coli, Proteus, Klebsiella, and Enterococcus species against multiple antimicrobial agents.

Key Conclusions and Perspectives

• Overall UTI positivity rate reached 10.44%, with significantly higher rates in females (13.04%) versus males (5.63%)
• Children aged 6-12 years and 13-18 years demonstrated significantly higher UTI positivity rates (11.99% and 12.5% respectively) compared to 1-5 year-olds
• E. coli showed high susceptibility to carbapenems (ertapenem, imipenem, meropenem) and fosfomycin (99.71%), with notable sensitivity to nitrofurantoin (96.01%)
• Ampicillin resistance reached maximum levels (62.28%), followed by trimethoprim-sulfamethoxazole (36.53%)
• Study findings indicate increasing E. coli susceptibility to ampicillin, amoxicillin-clavulanic acid, and cefotaxime over time, while exhibiting significant resistance escalation to norfloxacin
• Proteus species demonstrated high sensitivity to carbapenems and amikacin but complete resistance to nitrofurantoin
• Klebsiella species showed carbapenem and aminoglycoside susceptibility, with marked resistance to fluoroquinolones and fosfomycin

Research Significance and Prospects
The study provides crucial regional antimicrobial resistance data to guide empirical pediatric treatment protocols, highlighting the necessity for ongoing MDR strain monitoring. Future investigations should expand geographic coverage and implement regular resistance pattern updates to refine therapeutic and preventive interventions.

 

 

Conclusion
This study analyzed UTI positivity rates and antimicrobial resistance trends in non-hospitalized children from Arad County, Romania. Key findings include higher infection rates in females and older children, with Escherichia coli as the predominant pathogen. High susceptibility to carbapenems, fosfomycin, and certain fluoroquinolones was observed, while significant resistance to ampicillin and trimethoprim-sulfamethoxazole was documented. The findings provide essential guidance for clinical empirical treatment while recommending sustained resistance pattern monitoring to develop precision treatment strategies.

 

Constantin Catalin Marc, Maria Daniela Mot, Monica Licker, Alin Gabriel Mihu, and Tudor Rares Olariu. Trends in Positive Urine Culture Rates and Antimicrobial Resistance in Non-Hospitalized Children from Western Romania: A Retrospective Observational Study. Antibiotics.