Abstract

Background and Aim: Urinary tract infection is one of the most common childhood illnesses that can lead to complications such as hypertension and kidney failure. The aim of this study was to evaluate microbial resistance and sensitivity and to determine the relationship between urinary tract abnormalities and prior antibiotic use with microbial resistance.

Methods: This is a descriptive-analytic study on 90 patients with a positive urine culture. Urine culture samples were taken using one of the sampling methods (midstream clean catch, catheterization, urine bag, suprapubic aspiration) and ultrasonography was requested for all patients to evaluate urinary system abnormalities. Also, a history of prior antibiotic use was asked and recorded.

Results: Of all patients, 55.6% showed E.coli and 44.4% showed other bacteria in urine culture. 97.7% of patients' cultures were sensitive to imipenem, 82.2% to nitrofurantoin, and 77.8% to cefixime. 65% of patients' cultures showed resistance to nalidixic acid, 56.7% to co-trimoxazole, and 38.9% to ceftriaxone. There was a significant relationship between cefixime and amikacin antibiotic resistance with abnormal ultrasound and there was a significant relationship between antibiotic resistance to cefixime, ceftriaxone, co-trimoxazole, and duration of prior antibiotic use (p-value <0.05).

Conclusion: The most common pathogen in UTI was E.coli. The highest sensitivity was to imipenem, nitrofurantoin, and cefixime, and the highest resistance was to nalidixic acid, co-trimoxazole, and ceftriaxone. There was a relationship between urinary tract abnormalities and prior antibiotic use with microbial resistance, so it is suggested to use kidney ultrasound in all patients with urinary tract infection.