BMC pediatrics · 2025
The rising threat of antibiotic and multidrug resistance in neonatal urinary tract infections.
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Sağlam Mukaddes Kılıç, Yanaşoğlu Emine, Sav Nadide Melike, Kurt Fatih, Kocabay Kenan, Akbaş Emel, Sungur Mehmet Ali
Аннотация
UNLABELLED: OBJECTıVE: Urinary tract infections (UTIs) are one of the significant causes of sepsis in neonates. Currently, antimicrobial resistance (AMR) and multidrug-resistant (MDR) microorganisms have become an increasingly prevalent issue in newborns. This study aimed to evaluate the clinical and laboratory findings, causative organisms, associated urinary tract anomalies, AMR patterns, and factors influencing the development of MDR in neonatal UTIs.
METHODS: Microorganisms in urine cultures obtained through bladder catheterization from neonates were identified, and AMR profiles as well as MDR organisms were determined. Antibiotic susceptibility tests were performed using Kirby-Bauer disk diffusion method and VITEK 2 Compact system. The cultures were categorized into two groups: MDR and non-MDR. A retrospective evaluation was conducted to assess the impact of clinical, laboratory, and imaging data on the development of MDR.
RESULTS: Data from 51 neonatal UTIs between 2018 and 2024 were evaluated. The most common microorganisms were Esherichia coli (E. Coli) and Klebsiella pneumoniae (K. Pneumoniae). A total of 75% of the E. coli strains demonstrated resistance to ampicillin. Resistance rates of E. coli, K. pneumoniae, and Enterobacter spp. to gentamicin was 25%, 30.7%, and 80%, respectively. Among the microorganisms 55% of E. coli, 100% of Enterobacter spp., 38.5% of K. pneumoniae, and 20% of Enterococcus spp. were MDR. However, no significant correlation was found between MDR and clinical, laboratory, and imaging data. Blood cultures were obtained from all patients prior to the initiation of antibiotic therapy; however, no pathogenic microorganisms were isolated.
CONCLUSIONS: AMR and MDR in neonatal UTIs appear to be a serious problem. Treatment options in MDR UTIs remain limited, and it is particularly important to research on the pharmacokinetics and safety profiles of antimicrobials in children is essential to expand treatment options for pediatric populations worldwide.
METHODS: Microorganisms in urine cultures obtained through bladder catheterization from neonates were identified, and AMR profiles as well as MDR organisms were determined. Antibiotic susceptibility tests were performed using Kirby-Bauer disk diffusion method and VITEK 2 Compact system. The cultures were categorized into two groups: MDR and non-MDR. A retrospective evaluation was conducted to assess the impact of clinical, laboratory, and imaging data on the development of MDR.
RESULTS: Data from 51 neonatal UTIs between 2018 and 2024 were evaluated. The most common microorganisms were Esherichia coli (E. Coli) and Klebsiella pneumoniae (K. Pneumoniae). A total of 75% of the E. coli strains demonstrated resistance to ampicillin. Resistance rates of E. coli, K. pneumoniae, and Enterobacter spp. to gentamicin was 25%, 30.7%, and 80%, respectively. Among the microorganisms 55% of E. coli, 100% of Enterobacter spp., 38.5% of K. pneumoniae, and 20% of Enterococcus spp. were MDR. However, no significant correlation was found between MDR and clinical, laboratory, and imaging data. Blood cultures were obtained from all patients prior to the initiation of antibiotic therapy; however, no pathogenic microorganisms were isolated.
CONCLUSIONS: AMR and MDR in neonatal UTIs appear to be a serious problem. Treatment options in MDR UTIs remain limited, and it is particularly important to research on the pharmacokinetics and safety profiles of antimicrobials in children is essential to expand treatment options for pediatric populations worldwide.