Multidrug-resistant uropathogens in pediatric urinary tract ınfections: a multicenter retrospective trend analysis (2020-2024)

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dc.contributor.authorErdogan, Esra
dc.contributor.authorYetisgen, Azize
dc.contributor.authorDogan, Serpil
dc.contributor.authorSinanoglu, Muhammed Selcuk
dc.contributor.authorKilic, Fedli Emre
dc.contributor.authorKurt, Osman
dc.date.accessioned2026-04-04T13:37:35Z
dc.date.available2026-04-04T13:37:35Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractLarge-scale public health disruptions, including pandemics and natural disasters, may influence healthcare delivery, pathogen distribution, and antimicrobial resistance (AMR). This retrospective multicenter study evaluated uropathogen profiles and temporal trends in antibacterial resistance among hospitalized pediatric patients with urinary tract infections (UTIs) across periods corresponding to the COVID-19 pandemic, the February 6, 2023 Kahramanmara & scedil; earthquakes, and the post-earthquake phase in heavily affected regions of T & uuml;rkiye. Hospitalized pediatric patients (0-18 years) with culture-confirmed UTIs admitted between January 2020 and December 2024 to three tertiary care hospitals were included. Pathogen identification and antibacterial susceptibility testing were performed using standard microbiological methods in accordance with EUCAST criteria. Uropathogen distribution and resistance patterns were compared across predefined study periods. A total of 1131 pediatric patients were analyzed, of whom 54.29% were female. Gram-negative bacteria predominated (89.57%), with Escherichia coli (59.86%) and Klebsiella spp. (18.92%) being the most frequently isolated pathogens. Across the study periods, E. coli demonstrated significant increases in resistance to ampicillin (63.26% to 81.90%), ceftriaxone (41.99% to 53.76%), ceftazidime (39.46% to 63.10%), and trimethoprim-sulfamethoxazole (32.27% to 40.34%) (all p < 0.01). Among Klebsiella spp., a significant temporal increase was observed only for imipenem resistance, which rose from 18.64% during the COVID-19 period to 37.50% during the earthquake period before declining to 13.21% in the post-earthquake period (p = 0.021). Multidrug-resistant (MDR) phenotypes were predominantly detected among Gram-negative organisms, with the highest proportions observed in Serratia spp., Citrobacter spp., Enterobacter spp., and Pseudomonas spp., while MDR prevalence in E. coli was comparatively lower. Temporal variations in antibacterial resistance were observed among pediatric UTI pathogens during periods of major public health disruption. These findings highlight the importance of sustained regional surveillance and context-aware empiric treatment strategies in settings exposed to systemic healthcare stressors.
dc.description.sponsorshipHarran University
dc.description.sponsorshipOpen access funding provided by the Scientific and Technological Research Council of Turkiye (TUB & Idot;TAK).
dc.identifier.doi10.1007/s00210-026-05134-x
dc.identifier.issn0028-1298
dc.identifier.issn1432-1912
dc.identifier.scopus2-s2.0-105031103804
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1007/s00210-026-05134-x
dc.identifier.urihttps://hdl.handle.net/11616/109913
dc.identifier.wosWOS:001698896800001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofNaunyn-Schmiedebergs Archives of Pharmacology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectPediatric urinary tract infections
dc.subjectAntibacterial resistance
dc.subjectCOVID-19 pandemic
dc.subjectKahramanmara & scedil
dc.subjectearthquake
dc.subjectGram-negative bacteria
dc.subjectMultidrug-resistant pathogens
dc.titleMultidrug-resistant uropathogens in pediatric urinary tract ınfections: a multicenter retrospective trend analysis (2020-2024)
dc.typeArticle

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