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A one-year prospective study on the antibiotic resistance of E. coli strains isolated in urinary specimens of children hospitalized at the University Pediatric Medical Center in Novi Sad, Serbia

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Abstract

Purpose

Urinary tract infections (UTIs), the most common serious bacterial infections in children, are frequently caused by Escherichia coli. The purpose of this study was to investigate E. coli resistance/multidrug resistance to antibiotics most frequently used for UTIs.

Methods

Children 0–18 years of age, hospitalized at the University Pediatric Hospital in Novi Sad, Serbia, were included in a 1-year observational prospective study. The microbiological analysis was performed using the standard Kirby–Bauer disk diffusion method. The results were analyzed using WHONET 5.4 software.

Results

E. coli was isolated from 61.7 % of positive urine specimens. In general, higher average E. coli antibiotic resistance was found in infants and toddlers compared to children and adolescents (33.4 vs. 25.0 %) (p < 0.0001). Furthermore, it was observed that the average resistance to all the tested antibiotics was higher in boys than in girls (37.0 vs. 25.1 %) (p < 0.0001). E. coli was highly susceptible to piperacillin/tazobactam (>93.1 %), amikacin (86.3 %), quinolones (>75.0 %), and penems (>96.6 %). The prevalence of multiresistant E. coli strains was significantly higher in infants and toddlers (72.3 vs. 36.8 %) (p < 0.0001).

Conclusions

E. coli, a common cause of UTIs in children admitted to pediatric hospitals, is highly resistant/multidrug-resistant to commonly used antibiotics. Higher average resistance is found in infants and toddlers than in children and adolescents, as well as in boys compared to girls. These findings are important for the regional empiric therapy of UTIs and call for actions to decrease E. coli antibiotic resistance.

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Acknowledgments

Katarina Ilić’s work is supported by the Ministry of Education and Science, Republic of Serbia, Project No. 175064, 2011-2014. Part of the data collected within the first 5 months of the study were presented orally at the 16th World Congress of Basic and Clinical Pharmacology (Copenhagen, Denmark, 17–23 July 2010) and published in an abstract form in Basic and Clinical Pharmacology and Toxicology 2010; 107(Suppl 1), p. 135. The 12-month data were presented in a poster session of the 2011 Annual Meeting of the American Society for Clinical Pharmacology and Therapeutics (Dallas, Texas, USA, 2–5 March 2011) and published in an abstract form in Clinical Pharmacology and Therapeutics 2011; 89(Suppl 1), p. S64.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, P.O. Box 146, 11221, Belgrade, Republic of Serbia

    E. Jakovljević & K. Ilić

  2. Centre for Microbiology, Institute of Public Health of Vojvodina, Futoška 121, 21000, Novi Sad, Autonomous Province of Vojvodina, Republic of Serbia

    Z. Jelesić

  3. Institute for Child and Youth Health Care of Vojvodina, Hajduk Veljkova 10, Novi Sad, Autonomous Province of Vojvodina, Republic of Serbia

    G. Konstantinidis

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  1. E. Jakovljević
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Correspondence to K. Ilić.

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Jakovljević, E., Ilić, K., Jelesić, Z. et al. A one-year prospective study on the antibiotic resistance of E. coli strains isolated in urinary specimens of children hospitalized at the University Pediatric Medical Center in Novi Sad, Serbia. Infection 41, 1111–1119 (2013). https://doi.org/10.1007/s15010-013-0493-0

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