Multidrug-resistant bacteria causing pediatric urinary tract infections in outpatient medical settings

The treatment of urinary tract infections among children and adolescents in health care settings is becoming an increasing challenge due to elevated prevalence of isolated bacterial strains with multiple antibiotic resistance. Patients and methods. A cross-sectional study was conducted among children and adolescents aged 0–17 years with a positive urine culture in the period between January and June 2023. Multiple antibiotic resistance index (MARI) of uropathogens causing infections among individuals was measured. The bacterial isolates included in the study have public health importance since they often demonstrate cross- or co-resistance to multiple classes of antimicrobials. Results. 21.73% of Escherichia coli isolates and 66.66% of Proteus mirabilis isolates had MARI above 0.2, indicating high levels of resistance to aminopenicillins and second-generation cephalosporins. All isolates of Enterococcus faecalis had MARI ranging from 0.467 to 0.714 and reported a 100% resistance to trimethoprim/sulfamethoxazole, tetracyclines, second- and third-generation cephalosporins, and some aminoglycosides. Conclusion. The conducted study presents current and relevant information on the prevalence of uropathogens with multiple antibiotic resistance isolated from pediatric outpatients, which can be successfully used as a guide in determining the therapeutic approach in the outpatient medical care. Key words: children, urinary tract infections, multidrug-resistant uropathogens