{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:02:49Z","timestamp":1788868969540,"version":"build-2803163510"},"reference-count":66,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Haramaya university's postgraduate directorate"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nUrinary tract infections (UTIs) are common pediatric infections and contribute to high morbidity and mortality. At present, the antimicrobial resistance emergency has quadrupled worldwide and poses a serious threat to the treatment of patients. However, there have been few studies on UTIs in children in Ethiopia, particularly in the east.<\/jats:p>\n<\/jats:sec>\n\nObjective<\/jats:title>\nThis study aimed to assess the bacterial profile of urinary tract infections, their susceptibility to antimicrobial agents, and associated factors in under-five children at Hiwot Fana Specialized University Hospital, eastern Ethiopia.<\/jats:p>\n<\/jats:sec>\n\nMethod<\/jats:title>\nWe conducted hospital-based quantitative study on 332 consecutively selected under-five children from March 20 to June 10, 2021. Parents and guardians were interviewed to collect data using a structured questionnaire. Random urine samples were collected aseptically, and standard microbiological techniques were used to identify the bacteria and test for susceptibility to various antibiotics. Data were entered into Epi Info version 7 and exported to Statistical Package for the Social Sciences (SPSS) version 25 for analysis. Data were analyzed using descriptive analysis, bivariate, and multivariable logistic regression analysis. The crude odds ratio (COR) and adjusted odds ratio (AOR) with their respective 95% confidence intervals (CI) were used to determine the significance of the predictors. A p-value at a 95% confidence interval of less than 0.05 was considered statistically significant.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nThe overall prevalence of bacterial urinary tract infections was 80 (24.1%) 95% CI:19.40\u201329.00%). Most of the bacterial isolates 55 (68.75%) were gram-negative bacteria, predominantly E<\/jats:italic>. coli<\/jats:italic> 23 (28.75%) and K<\/jats:italic>. pneumoniae<\/jats:italic> 10 (12.50%). Being a rural resident (AOR: 4.10, 95%CI: 1.45 11.54), uncircumcised male (AOR: 3.52, 95%CI: 1.33, 9.39), previous history of antibiotic usage (AOR: 7.32, 95%CI: 2.11, 25.37), indwelling catheterization (AOR: 10.35, 95%CI: 3.74, 28.63), previous history of urinary tract infections (AOR: 5.64, 95% CI: 1.36, 23.38), and urinary frequency (AOR: 5.56, 95%CI: 2.03, 15.25) had higher odds of culture positive result. The majority of the isolates have shown high levels of antibiotic resistance. Meropenem, ciprofloxacin, and amoxicillin-clavulanic acid were effective against gram-negative uropathogens, whereas rifampin and ciprofloxacin were the most sensitive drugs for gram-positive isolates. From the tested bacterial isolates, 53\/86 (61.6%), 11\/86 (11.6%), and 2\/86 (2.3%) were found to have multidrug resistance (MDR), extreme drug resistance (XDR), and pan drug resistance (PDR), respectively.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nAbout one-fourth of the children were culture-positive for many types of bacterial uropathogens; this is higher compared with most of the previous studies in Africa. Rural dwellers, uncircumcised males, indwelling catheterization, a history of antibiotic use and urinary tract infection, and frequent urination all had a higher risk of bacterial infections. Many isolates were resistant to multiple drugs, primarily beta-lactams. Urinary tract infections as well as the growth and spread of resistant bacterial pathogens should be monitor regularly.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0283637","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T17:47:47Z","timestamp":1680716867000},"page":"e0283637","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":28,"title":["Bacterial profile, their antibiotic susceptibility pattern, and associated factors of urinary tract infections in children at Hiwot Fana Specialized University Hospital, Eastern Ethiopia"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6521-542X","authenticated-orcid":true,"given":"Shambel","family":"Mekonnen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8274-2179","authenticated-orcid":true,"given":"Tewodros","family":"Tesfa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadesse","family":"Shume","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fikru","family":"Tebeje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kedir","family":"Urgesa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fitsum","family":"Weldegebreal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,4,5]]},"reference":[{"issue":"1","key":"pone.0283637.ref001","first-page":"7","article-title":"Childhood urinary tract pathogens and antibiotic susceptibility seen at Gusau, Nigeria","volume":"10","author":"GIBI Garba","year":"2015","journal-title":"Tropical Journal of Nephrology"},{"issue":"5","key":"pone.0283637.ref002","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/nrmicro3432","article-title":"Urinary tract infections: epidemiology, mechanisms of infection and treatment options","volume":"13","author":"AL Flores-Mireles","year":"2015","journal-title":"Nature reviews microbiology"},{"issue":"1","key":"pone.0283637.ref003","doi-asserted-by":"crossref","first-page":"01","DOI":"10.13005\/bpj\/376","article-title":"Urinary tract infections among pregnant women in Makkah, Saudi Arabia","volume":"6","author":"HS Faidah","year":"2015","journal-title":"Biomedical And Pharmacology Journal"},{"issue":"6","key":"pone.0283637.ref004","doi-asserted-by":"crossref","first-page":"543","DOI":"10.3923\/jm.2011.543.551","article-title":"Prevalence, microbiologic profile of urinary tract infection and its treatment with trimethoprim in diabetic patients","volume":"6","author":"G Sibi","year":"2011","journal-title":"Research journal of microbiology"},{"issue":"11","key":"pone.0283637.ref005","doi-asserted-by":"crossref","first-page":"e0259602","DOI":"10.1371\/journal.pone.0259602","article-title":"Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute","volume":"16","author":"T Addis","year":"2021","journal-title":"PloS one"},{"issue":"2","key":"pone.0283637.ref006","first-page":"3","article-title":"Urinary tract infection: an overview of the infection and the associated risk factors","volume":"1","author":"V. 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