Community- and hospital-acquired urinary tract infection spectrum of uropathogens and their antibiotic susceptibility patterns comparison among children

Object and methods of research: The data of 164 patients urine cultures were collected from The Hospital of Lithuanian University of Health Sciences Kaunas Clinics in Microbiology laboratory (from children in 2016 year). In order to determine the type of urinary tract infection, medical records of patients were analyzed. Analysis of the data collected during this research was performed using SPSS 25.0 package, tabulation were created using Microsoft Office Excel 2007 program. Results: The analysis of urine cultures showed that E. coli was accounted for the largest part of detected uropathogens - 76.2%, E. faecalis - 8.5%, K. pneumoniae - 4.3%, C. koseri – 2.4%, P. mirabilis - 1.8%, E.cloacae, P. aeruginosa, S. aureus, C. albicans - 1.2%, E. asburiae, K. oxytoca, S. agalactiae - 0.6%. 90% of urinary tract infections were community-acquired and 10% nosocomial. In this study, the frequencies of microorganisms acquired in the community and in the hospital were different. In community-acquired urinary tract infections E. coli made up 80.4%, E. faecalis - 8.1%, K. pneumoniae - 2.7%, other microorganisms accounted for less than 1.4%. E. coli had a lower percentage in nosocomial infections than in the community-acquired urinary tract infections - 37.5%, among hospital-acquired urinary tract infections more infections were caused by K. pneumoniae - 18.8%, E. faecalis, C. koseri, S. aureus - 12.5%, P. mirabilis - 6.2%. S. aureus was detected only among infectious agents acquired in a hospital. The highest sensitivity of E. coli was to nitrofurantoin (99.2%), cefuroxime (97.6%), ciprofloxacin (97.6%), gentamycin (97.6%). E. coli bacteria were less susceptible to trimethoprim (85.6%). The lowest E. coli susceptibility was to ampicilin (64.8%). All E. faecalis bacteria were susceptible to ampicillin, vancomycin, nitrofurantoin, linezolid and 97% were susceptible to ciprofloxacin. In this study, the highest sensitivity of K. pneumoniae was for ciprofloxacin (86.0%). In addition to the natural resistance to ampicillin, significant resistance was observed for cefuroxime, gentamycin, nitrofurantoin and trimethoprim – 57.0%. In this study, there was no statistically significant difference between hospital and community-aquired E. coli resistance to antibiotics (p> 0.05). Conclusion: 1. During this study, we found that the most common causative agent of urinary tract infections in children was E. coli. 2. The most effective antibiotic against E. coli was nitrofurantoin. The least effective antibiotic against E. coli was ampicillin. 3. The most common uropathogen in children in the community-aquired urinary tract infections was E. coli, the second most common uropathogen was E. faecalis. In the case of hospital-acquired infections, E. coli also was the most common causative agent followed by K. pneumoniae, S. aureus, Citrobacter koseri and Enterococcus faecalis. After comparing the most common hospital and community-aquired urinary tract infection uropathogens sensitivities to antibiotics, no statistically significant differences were detected