Microbiological characteristics and antimicrobial resistance of pathogens isolated in urine cultures from patients hospitalized in a pediatric service

Abstract

Introduction: Antimicrobial resistance in pediatric infections represents a growing challenge for public health. In Paraguay, there is limited information about resistance patterns in the pediatric population, especially in hospital centers outside the capital. Objective: To determine the frequency of antimicrobial resistance of germs isolated in urine cultures of patients admitted to the pediatric service of the General Hospital of Luque, during the period from October 2023 to October 2024. Methodology: Observational, descriptive, and retrospective study. Medical records and laboratory results of 121 hospitalized pediatric patients who underwent urine culture were analyzed. Demographic characteristics, microbiological results, antimicrobial resistance and sensitivity patterns, and treatments used were evaluated. Results: During the study period, 121 patients with a diagnosis of urinary tract infection were hospitalized, of which 67.77% were female patients, with a predominance of <1 year of age (38.02%). Of the total urine cultures, 32.81% were positive, with a predominance of monomicrobial cultures (85.71%). Escherichia coli was the most frequent pathogen (69.23%), followed by Klebsiella pneumoniae (7.69%). ESBL strains were identified in 7.69% of cases. The highest resistance was observed against Ampicillin/Sulbactam (35.71%) and Cotrimoxazole (23.81%), while the highest sensitivity was to Gentamicin (69.05%) and Cefazolin (57.14%). The most commonly used treatment was cefotaxime (58.67%), with a predominant duration of 4-7 days (70.25% of cases). Conclusion: The findings demonstrate a considerable frequency of antimicrobial resistance, with specific patterns that should be considered in the selection of initial empirical treatment. The high prevalence of E. coli and the emergence of ESBL strains underscore the relevance of constant surveillance and the need to establish strategies for rational antibiotic use in the pediatric population.