Prevalence, Risk Factors, and Antibiotic Susceptibility of ESBL-Producing Uropathogens in Community-Acquired Pediatric Urinary Tract Infections at a Tertiary Center in Riyadh, Saudi Arabia

Background Pediatric urinary tract infections (UTIs) are a global public health concern, exacerbated by rising antibiotic resistance rates, including extended-spectrum beta-lactamase (ESBL) producers. In Saudi Arabia, the epidemiology of pediatric UTIs varies regionally, necessitating localized studies to guide effective management strategies. Objectives This study aims to analyze the epidemiology and antibiotic resistance profiles of pediatric community-acquired UTIs in a tertiary care setting at King Saud Medical City (KSMC), Riyadh, to inform localized management strategies. Methods A retrospective study was conducted analyzing data from 803 pediatric patients (aged 1 month to 14 years) with initial UTIs at King Saud Medical City, Riyadh, between 2016 and 2018. Demographic data, urine culture results, and antibiotic resistance profiles were extracted from electronic medical records. Statistical analyses, including chi-square tests and logistic regression, were used to assess associations and predictors of antibiotic resistance. Results Escherichia coli was identified as the most common uropathogen (40.5%), followed by Klebsiella pneumoniae (21.5%) and Enterococcus species (12.7%). ESBL producers accounted for 24.61% of the isolates, significantly influencing the choice of empirical therapy. High antibiotic resistance rates were observed, particularly for ampicillin (43%), cotrimoxazole (26.8%), and cefazolin (CFZ; 50%). Notably, the prevalence of ESBL-producing uropathogens varied significantly by gender and pathogen type. Conclusion This study provides important insights into the epidemiology of pediatric community-acquired UTIs and antibiotic susceptibility in Saudi Arabia. Due to the high prevalence of ESBL-producing uropathogens, individualized management strategies for antibiotic use are essential. Local studies are crucial for informing empirical treatment and improving clinical outcomes in managing pediatric UTIs.