World Journal of
Pharmaceutical and Life Sciences

FACTORS ASSOCIATED WITH ANTIBIOTIC SENSITIVITY AND RESISTANCE IN CHILDREN WITH URINARY TRACT INFECTION

Kambiz Ghasemi*

ABSTRACT

Background: Urinary tract infections (UTIs) are among the most common bacterial infection of childhood. We aimed to investigate the factors influencing sensitivity and resistance to antibiotics in children with UTI. Methods: This cross-sectional study included children with culture-confirmed UTI, aged 2 months to 14 years, admitted to Bandar Abbas Children’s Hospital, Bandar Abbas, Iran, 2017-2018. Disc antibiogram was used to determine antibiotic sensitivity and resistance. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were also measured in all participants. Results: Of the 200 children included in this study with a mean age of 2.58 ± 2.81 years, 39 (19.5%) were male. Escherichia coli was more prevalent in girls by 16.5%. Gender and resistance to antibiotics were not correlated (P>0.05). Patients with constipation were significantly outnumbered by those without constipation regarding sensitivity to amikacin and nitrofurantoin (70.4% vs 89.2%, P=0.012, and 75% vs 96%, P=0.002, respectively). Sensitivity to imipenem was higher in summer (86%, P=0.007), and to nitrofurantoin in autumn (75%, P=0.008). Fewer subjects with prior antibiotic intake were sensitive to ciprofloxacin compared to those without such history (P=0.016). Sensitivity to antibiotics was neither significantly correlated with hydronephrosis or anatomical abnormalities, nor with labial adhesion, yet 100% of patients with labial adhesion were sensitive to cotrimoxazole (P=0.009). No significant relationship was observed between antibiotic resistance and ESR or CRP levels, except for significantly lower CRP in patients resistant to ceftazidime compared to those sensitive to it (P=0.027). Conclusions: Resistance to antibiotics was not influenced by gender, hydronephrosis, anatomical abnormalities, labial adhesion (to a great extent), ESR, and CRP (with one exception), while it was affected by the presence of constipation, prior antibiotic intake, and change in seasons.

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