title: Causative pathogens and antibiotic resistance in children hospitalized for urinary tract infection.
abstract: BACKGROUND
  Urinary tract infections (UTI) are one of the most common bacterial infections in children and a major cause of hospitalization. In this study we investigated the clinical characteristics, causative uropathogens; their antibiotic susceptibility and resistance patterns, treatment modalities and efficacy in children hospitalized for UTI in a tertiary care setting.
  
  
  METHODS
  Patients hospitalized for an upper UTI between March 2009 and July 2014 were enrolled. The urine culture-antibiogram results and accompanying urinary tract abnormalities were recorded retrospectively.
  
  
  RESULTS
  A total of 142 patients (104 girls, 73.2%; 38 boys, 26.8%) were enrolled. Mean patient age was 32.6 ± 4.1 months. History of recurrent UTI was present in 45.8% (n = 65), with prior hospitalization in 12.0% (n = 17). Frequency of vesicoureteral reflux was 18.3% (n = 26). Gram-negative enteric microorganisms yielded growth in all culture-positive UTI and the most common microorganism was Escherichia coli (n = 114, 80.3%). Extended spectrum beta-lactamase-producing (ESBL (+)) bacterial strains were detected in 49.3% (n = 70), with third-generation cephalosporin resistance in all and increased duration of hospitalization.
  
  
  CONCLUSIONS
  The prevalence of UTI with ESBL (+) bacterial strains with multi-drug resistance is increasing in the hospitalized pediatric population, therefore rational use of antibiotics is essential.
authors.affiliation: Department of Pediatrics, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Koçak
authors.affiliation: Department of Pediatric Nephrology, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Bahar
authors.initials: B
authors.lastname: Büyükkaragöz
authors.affiliation: Department of Pediatric Nephrology, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Asli
authors.initials: A
authors.lastname: Çelebi Tayfur
authors.affiliation: Department of Pediatric Nephrology, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Çaltik
authors.affiliation: Department of Pediatrics, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Adem Yasin
authors.initials: AY
authors.lastname: Köksoy
authors.affiliation: Department of Microbiology, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Çizmeci
authors.affiliation: Department of Pediatrics, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Sacit
authors.initials: S
authors.lastname: Günbey
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic resistance; children; extended spectrum beta-lactamase; hospitalization; urinary tract infection