PREVALENCE OF ANTIBIOTIC RESISTANCE IN PEDIATRIC URINARY TRACT INFECTION CASES: A CROSS-SECTIONAL STUDY

Abstract

Background:
Pediatric urinary tract infections (UTIs) are a common clinical concern, with increasing resistance to empirical antibiotics posing a major challenge to effective management. Local resistance surveillance is essential for guiding appropriate treatment strategies.

Objective:
To assess the frequency and resistance patterns of uropathogens isolated from pediatric UTI cases in a tertiary care hospital in Lahore.

Methods:
A cross-sectional study was conducted over eight months, enrolling 422 children aged 1 month to 12 years with culture-confirmed UTIs. Urine samples were processed using standard microbiological techniques. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method according to CLSI guidelines. Data were analyzed using SPSS v26, with statistical significance set at p<0.05.

Results:
Escherichia coli was the most prevalent uropathogen (69.2%), followed by Klebsiella pneumoniae (13.7%) and Proteus mirabilis (5.7%). High resistance rates were observed in E. coli to ampicillin (84.6%), co-trimoxazole (65.1%), and cefixime (52.3%). Nitrofurantoin (13.4%) and meropenem (3.4%) showed the lowest resistance. Multidrug resistance was identified in 53.4% of E. coli and 65.5% of Klebsiella isolates. The findings reveal a concerning trend of diminished efficacy of first-line antibiotics in pediatric UTIs.

Conclusion:
The high prevalence of resistant and multidrug-resistant uropathogens necessitates routine local antibiogram development to inform empirical therapy in pediatric UTIs. Optimized antimicrobial stewardship and updated treatment guidelines are critical for preserving antibiotic efficacy in this vulnerable population.