Comparison of type and antibiotic resistance of microorganisms causing pyelonephritis in children with and without functional constipation

Background. As mentioned, in this study we compared the type of microorganisms causing pyelonephritis and their resistance in two groups of children with and without constipation. This issue is very important in the clinic in initial empirical treatment (before culture results are reported) and antibiotic selection. The number of microorganisms that cause pyelonephritis is large. We cannot limit the identification and comparison of microorganisms that cause pyelonephritis (for example, to two or three types) and also their resistance. Methods. This cross-sectional study investigated the children with pyelonephritis and admitted to Amirkola children hospital in Babol, Iran between 2014-2021. The census method was adopted to include the children in the study based on the inclusion criteria. All children aged between two months and 18 years and without consumption of any oral or injection of antibiotic 48 hours before admission were enrolled. The microorganism sensitivity and drug resistance were evaluated using the disk diffusion antibiogram and the guidelines by Clinical and Laboratory Standard Institute (CLSI). Constipation was diagnosed based on the criteria of ROME III, IV and confirm a gastroenterologist. Results. Out of 270 children with pyelonephritis, nearly 56 (%20.7) children had functional constipation. Nitrofurantoin (%95.2) and Ampicillin (%67.2) were the most sensitive and resistant drugs. Escherichia coli was the most common microorganism in both groups (P<0.05), and no difference was detected between two groups in terms of the drug sensitivity or resistance (P<0.05). Conclusion. In sum, roughly one fifth of the children with pyelonephritis had functional constipation. The microorganisms causing pyelonephritis in children with and without functional constipation were not different in terms of the type and antibiotic resistance. Practical Implications. An initial empiric treatment may have been used for children with pyelonephritis in both study groups (i.e., children with and without functional constipation) based on a common protocol.