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Background <p>We assessed pathogens, risk factors, and antibiotic non-susceptibility (ANS) rates in order to optimize the empiric antibiotic therapy for children and adolescents admitted with urinary tract infection (UTI).</p> Methods <p>A retrospective case-control study was conducted on children and adolescents aged 3 months to 18 years discharged with a complicated UTI (cUTI) diagnosis from two Israeli tertiary care pediatric centers (2018–2021). The control group included children and adolescents diagnosed with simple UTIs (sUTI) during the study period.</p> Results <p>234 children with a mean age of 3.8 years were included. Male sex and previous antibiotic treatment in the last 3 months (therapeutic and prophylactic) were significantly higher in the cUTI group (26.8% vs. 11.2%. and 59.8% vs. 9.9%, respectively). <i>Escherichia coli</i> was the most common pathogen, especially in sUTIs, while cUTIs showed a more diverse profile, including <i>Pseudomonas aeruginosa</i>. cUTIs were independent predictors of multidrug-resistant (MDR) and extended-spectrum b lactamases (ESBL) producing bacteria that comprise 23% of the enterobacteria in this group,</p> Conclusions <p>Our findings emphasize the need for empirical treatment for cUTIs that include antipseudomonal agents and ESBL coverage. Cephalosporins are not optimal empiric treatment in this group, while amikacin demonstrated 100% susceptibility, making it more appropriate for initial empiric therapy. Ongoing surveillance is warranted to monitor antimicrobial resistance and guide appropriate empiric treatment.</p>

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Pathogen distribution and antimicrobial resistance in simple and complicated urinary tract infections in pediatric patients

  • 期刊论文

  • 发表日期：

    2026年1月7日

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  • Elad Libo,
  • Tal Weiss,
  • Ilan Youngster,
  • Amos Adler,
  • Galia Grisaru-Soen

摘要

Background

We assessed pathogens, risk factors, and antibiotic non-susceptibility (ANS) rates in order to optimize the empiric antibiotic therapy for children and adolescents admitted with urinary tract infection (UTI).

Methods

A retrospective case-control study was conducted on children and adolescents aged 3 months to 18 years discharged with a complicated UTI (cUTI) diagnosis from two Israeli tertiary care pediatric centers (2018–2021). The control group included children and adolescents diagnosed with simple UTIs (sUTI) during the study period.

Results

234 children with a mean age of 3.8 years were included. Male sex and previous antibiotic treatment in the last 3 months (therapeutic and prophylactic) were significantly higher in the cUTI group (26.8% vs. 11.2%. and 59.8% vs. 9.9%, respectively). Escherichia coli was the most common pathogen, especially in sUTIs, while cUTIs showed a more diverse profile, including Pseudomonas aeruginosa. cUTIs were independent predictors of multidrug-resistant (MDR) and extended-spectrum b lactamases (ESBL) producing bacteria that comprise 23% of the enterobacteria in this group,

Conclusions

Our findings emphasize the need for empirical treatment for cUTIs that include antipseudomonal agents and ESBL coverage. Cephalosporins are not optimal empiric treatment in this group, while amikacin demonstrated 100% susceptibility, making it more appropriate for initial empiric therapy. Ongoing surveillance is warranted to monitor antimicrobial resistance and guide appropriate empiric treatment.