title: Bacterial pathogens and antibiotic resistance patterns in children with urinary tract infection in a Malaysian tertiary hospital.
abstract: BACKGROUND
  Urinary tract infection (UTI) is a common bacterial infection affecting children and therefore, prompt recognition and accurate antimicrobial management are vital to prevent kidney damage. This study aims to determine the bacterial pathogens and their patterns of antimicrobial resistance in children presenting with UTI.
  
  
  METHODS
  A retrospective study of 721 cases, involving children between the ages of 1-day old to 13 years old with culture-proven UTI in Selayang Hospital, Malaysia between January 2007 and December 2011. The bacterial pathogens and antibiotic resistance patterns in the total population, prophylaxis and no prophylaxis groups were studied.
  
  
  RESULTS
  The 3 most common organisms isolated in the total population were E.Coli (41.6%), Klebsiella spp. (21.2%) and Enterococcus spp. (11.0%). With regards to the antibiotic resistance, E.Coli resistance rates to ampicillin, cefuroxime and gentamicin were 67.7%, 15.3% and 7.3% respectively. Ampicillin-resistance was also highest in Klebsiella spp. (84.3%), Enterococcus spp. (15.5%) and Proteus spp. (55.5%).
  
  
  CONCLUSIONS
  E.coli remains to be the leading bacterial pathogen causing UTI in children, with ampicillin-resistance occurring in more than half of these cases. Therefore, accurate choice of antibiotics is important to ensure optimal outcome. In our study, cefuroxime and gentamicin have lower antibiotic resistance rates and can be used in the treatment of UTI in children.
authors.affiliation: Universiti Teknologi MARA(UiTM), Faculty of Medicine, Women and Child Health Cluster, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia. shafinamohdnor@yahoo.com.
authors.forename: M N
authors.initials: MN
authors.lastname: Noor Shafina
authors.affiliation: Universiti Teknologi MARA(UiTM), Faculty of Medicine, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
authors.forename: A
authors.initials: A
authors.lastname: Nor Azizah
authors.affiliation: Universiti Teknologi MARA(UiTM), Faculty of Medicine, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
authors.forename: A R
authors.initials: AR
authors.lastname: Mohammad
authors.affiliation: Universiti Teknologi MARA(UiTM), Faculty of Medicine, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
authors.forename: M F
authors.initials: MF
authors.lastname: Faisal
authors.affiliation: Universiti Teknologi MARA(UiTM), Faculty of Medicine, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
authors.forename: S
authors.initials: S
authors.lastname: Mohamad Ikhsan
authors.affiliation: Universiti Teknologi MARA(UiTM), Faculty of Medicine, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
authors.forename: Z
authors.initials: Z
authors.lastname: Hafizah
authors.affiliation: Universiti Teknologi MARA(UiTM), Faculty of Medicine, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
authors.forename: Z A
authors.initials: ZA
authors.lastname: Anis Siham
authors.affiliation: Hospital Selayang, Department of Paediatrics, Selangor, Malaysia.
authors.forename: W I
authors.initials: WI
authors.lastname: Wan Jazilah
authors.affiliation: Universiti Teknologi MARA(UiTM), Faculty of Medicine, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
authors.forename: R A R
authors.initials: RA
authors.lastname: Raja Khuzaiah