{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:55:53Z","timestamp":1792803353725,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVICTOR BABES\u201d UNIVERSITY OF MEDICINE AND PHARMACY TIMISOARA","id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Urinary tract infection (UTI) represents one of the most common bacterial infections in children, mainly caused by Gram-negative bacteria. Empirical antibiotic treatment is based on international and national guidelines for treating UTIs in children and is individualized with local antibiotic resistance patterns. The aim of this study is to bring a clear view of present-day particularities of UTIs in children. Methods: We analyzed 210 positive urine cultures identified in 141 pediatric patients admitted to the hospital over a 6-month period. Results: The majority of patients were females (57%) with a median age of 5 years (IQR 12), while male patients revealed a median age of 2 (IQR 7). Most patients originated from urban areas (53%). Only 18 patients (12.76%) were identified with underlying Congenital Anomalies of the Kidney and Urinary Tract (CAKUT). Escherichia Coli was the most frequent pathogen. Increased antibiotic resistance was found in commonly-used antibiotics Ampicillin and Trimethoprim\/Sulfamethoxazole, and in the case of patients with CAKUT. Suitable antibiotics for treating a Gram-negative UTI are aminoglycosides, Meropenem, third-generation Cephalosporins, and Nitrofurantoin. Vancomycin upholds efficacy in treating a Gram-positive pediatric UTI. Conclusion: Periodical analysis needs to be performed in order to constantly update clinicians on uropathogenic antibiotic resistance and optimal empirical treatment options.<\/jats:p>","DOI":"10.3390\/antibiotics13080684","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T14:55:47Z","timestamp":1721832947000},"page":"684","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["General Characteristics and Current State of Antibiotic Resistance in Pediatric Urinary Tract Infection\u2014A Single Center Experience"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1478-9797","authenticated-orcid":false,"given":"Raluca","family":"Isac","sequence":"first","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Hospital for Children \u201cLouis Turcanu\u201d, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Doros","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Hospital for Children \u201cLouis Turcanu\u201d, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana-Alexandra","family":"Stolojanu","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxandra Maria","family":"Steflea","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Hospital for Children \u201cLouis Turcanu\u201d, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4403-0581","authenticated-orcid":false,"given":"Ramona Florina","family":"Stroescu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Hospital for Children \u201cLouis Turcanu\u201d, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4800-0451","authenticated-orcid":false,"given":"Ioana-Cristina","family":"Olariu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Hospital for Children \u201cLouis Turcanu\u201d, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6831-4776","authenticated-orcid":false,"given":"Andrada-Mara","family":"Micsescu-Olah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Hospital for Children \u201cLouis Turcanu\u201d, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9029-5919","authenticated-orcid":false,"given":"Mihai","family":"Gafencu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Hospital for Children \u201cLouis Turcanu\u201d, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jpurol.2021.01.037","article-title":"Update of the EAU\/ESPU guidelines on urinary tract infections in children","volume":"17","author":"Bogaert","year":"2021","journal-title":"J. Pediatr. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.urology.2021.12.027","article-title":"Risk factors for recurrent urinary tract infection in children with neurogenic bladder following clean intermittent catheterization","volume":"164","author":"Jiang","year":"2022","journal-title":"Urology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1016\/S0140-6736(20)30676-0","article-title":"Urinary tract infections in children","volume":"395","author":"Tullus","year":"2020","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.ucl.2010.03.009","article-title":"Urinary tract infection in children: When to worry","volume":"37","author":"Clark","year":"2010","journal-title":"Urol. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.pcl.2006.02.011","article-title":"Pediatric urinary tract infections","volume":"53","author":"Chang","year":"2006","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1542\/peds.2011-1330","article-title":"Urinary tract infection: Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months","volume":"128","author":"Roberts","year":"2011","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"748","DOI":"10.3892\/etm.2021.10180","article-title":"Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania","volume":"22","author":"Duicu","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Borcan, A.M., Radu, G., Simoiu, M., Costea, E.L., and Rafila, A. (2024). A Five-Year Analysis of Antibiotic Resistance Trends among Bacteria Identified in Positive Urine Samples in a Tertiary Care Hospital from Bucharest, Romania. Antibiotics, 13.","DOI":"10.3390\/antibiotics13020160"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Isac, R., Basaca, D.G., Olariu, I.C., Stroescu, R.F., Ardelean, A.M., Steflea, R.M., Gafencu, M., Chirita-Emandi, A., Bagiu, I.C., and Horhat, F.G. (2021). Antibiotic resistance patterns of uropathogens causing urinary tract infections in children with congenital anomalies of kidney and urinary tract. Children, 8.","DOI":"10.3390\/children8070585"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"583","DOI":"10.18683\/germs.2021.1293","article-title":"Urinary tract infections in children: Clinical and antimicrobial resistance data from Bucharest area, Romania","volume":"11","author":"Miron","year":"2021","journal-title":"Germs"},{"key":"ref_11","first-page":"17","article-title":"Prevalence Spectrum and Antibiotic Resistance in Uncomplicated Urinary Tract Infections in Romanian Population: From Guideline to Clinical Practice","volume":"20","author":"Cosmin","year":"2021","journal-title":"Rom. J. Urol."},{"key":"ref_12","unstructured":"National Collaborating Centre for Women\u2019s and Children\u2019s Health (2024, May 17). Urinary Tract Infection in Children: Diagnosis, Treatment and Long-Term Management. Available online: http:\/\/guidance.nice.org.uk\/CG54."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/apa.14988","article-title":"Updated Italian recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children","volume":"109","author":"Ammenti","year":"2020","journal-title":"Acta Paediatr."},{"key":"ref_14","unstructured":"World Health Organization (WHO) (2015). Global Action Plan on Antimicrobial Resistance, WHO. Available online: https:\/\/www.who.int\/antimicrobial-resistance\/global-action-plan\/en\/."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/jac\/dkv418","article-title":"The Worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children","volume":"71","author":"Versporten","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"745","DOI":"10.2165\/11591180-000000000-00000","article-title":"European surveillance of antimicrobial consumption (ESAC) value of a point-prevalence survey of antimicrobial use across europe","volume":"71","author":"Zarb","year":"2011","journal-title":"Drugs"},{"key":"ref_17","first-page":"16","article-title":"Microbial etiology and antibiotic resistance in urinary tract infections in children; view from an area where antibiotics are overused","volume":"27","author":"Samanci","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/INF.0b013e31815e4122","article-title":"Prevalence of urinary tract infection in childhood: A meta-analysis","volume":"27","author":"Shaikh","year":"2008","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.eururo.2014.11.007","article-title":"Urinary tract infections in children: EAU\/ESPU guidelines","volume":"67","author":"Stein","year":"2015","journal-title":"Eur. Urol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1038\/s41385-022-00549-0","article-title":"The impact of biological sex on diseases of the urinary tract","volume":"15","author":"Deltourbe","year":"2022","journal-title":"Mucosal Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Whiting, P., Westwood, M., Watt, I., Cooper, J., and Kleijnen, J. (2005). Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: A systematic review. BMC Pediatr., 5.","DOI":"10.1186\/1471-2431-5-4"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Autore, G., Bernardi, L., Ghidini, F., La Scola, C., Berardi, A., Biasucci, G., Marchetti, F., Pasini, A., Capra, M.E., and Castellini, C. (2023). Antibiotic prophylaxis for the prevention of urinary tract infections in children: Guideline and recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) study group. Antibiotics, 12.","DOI":"10.3390\/antibiotics12061040"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/iju.14223","article-title":"Guidelines for the medical management of pediatric vesicoureteral reflux","volume":"27","author":"Miyakita","year":"2020","journal-title":"Int. J. Urol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e2020012138","DOI":"10.1542\/peds.2020-012138","article-title":"Contemporary Management of Urinary Tract Infection in Children","volume":"147","author":"Mattoo","year":"2021","journal-title":"Pediatrics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"113","DOI":"10.4103\/ua.ua_147_22","article-title":"Urinary tract infection in children: A narrative review of clinical practice guidelines","volume":"15","author":"Alsaywid","year":"2023","journal-title":"Urol. Ann."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.2147\/IDR.S293279","article-title":"Resistance patterns from urine cultures in children aged 0 to 6 years: Implications for empirical antibiotic choice","volume":"23","author":"Montagnani","year":"2021","journal-title":"Infect. Drug Resist."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4103\/ijpvm.IJPVM_419_17","article-title":"Pattern of antibacterial resistance in urinary tract infections: A systematic review and meta-analysis","volume":"10","author":"Ghaderkhani","year":"2019","journal-title":"Int. J. Prev. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1136\/adc.88.5.444","article-title":"Increasing antibiotic resistance among urinary tract isolates","volume":"88","author":"Ladhani","year":"2003","journal-title":"Arch. Dis. Child."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1542\/pir.2017-0007","article-title":"Urinary Tract Infections in Children","volume":"39","author":"Balighian","year":"2018","journal-title":"Pediatr. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.ucl.2015.05.011","article-title":"Work-up of Pediatric Urinary Tract Infection","volume":"42","author":"Schmidt","year":"2015","journal-title":"Urol. Clin. N. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1542\/pir.36.4.153","article-title":"Urinary tract infections in children: Knowledge updates and a salute to the future","volume":"36","author":"Jackson","year":"2015","journal-title":"Pediatr. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1097\/01.pec.0000226872.31501.d0","article-title":"Racial and ethnic differences in the rates of urinary tract infections in febrile infants in the emergency department","volume":"22","author":"Chen","year":"2006","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2777","DOI":"10.1007\/s00467-021-05042-7","article-title":"Risk factors for kidney scarring and vesicoureteral reflux in 421 children after their first acute pyelonephritis, and appraisal of international guidelines","volume":"36","author":"Breinbjerg","year":"2021","journal-title":"Pediatr. Nephrol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Autore, G., Neglia, C., Di Costanzo, M., Ceccoli, M., Vergine, G., La Scola, C., Malaventura, C., Falcioni, A., Iacono, A., and Crisafi, A. (2022). Clinical Outcome of Discordant Empirical Therapy and Risk Factors Associated to Treatment Failure in Children Hospitalized for Urinary Tract Infections. Children, 9.","DOI":"10.3390\/children9020128"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Dar, A., Abram, T.B., and Megged, O. (2024). Impact of inadequate empirical antibiotic treatment on outcome of non-critically ill children with bacterial infections. BMC Pediatr., 24.","DOI":"10.1186\/s12887-024-04793-0"},{"key":"ref_36","first-page":"1","article-title":"Therapeutics of Pediatric Urinary Tract Infections","volume":"7","author":"Espinosa","year":"2015","journal-title":"Arch. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e1034","DOI":"10.1542\/peds.2011-1496","article-title":"The Use of Systemic and Topical Fluoroquinolones","volume":"128","author":"Bradley","year":"2011","journal-title":"Pediatrics"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"ofad297","DOI":"10.1093\/ofid\/ofad297","article-title":"Fluoroquinolone Use Among Hospitalized Children: Diagnosis-Based Stratification to Identify Stewardship Targets","volume":"10","author":"Sun","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"ref_39","first-page":"30","article-title":"Clinical pharmacology of fluoroquinolones in infants and children","volume":"2","author":"Pacifici","year":"2023","journal-title":"World J. Clin. Med. Images"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Rusu, A., Munteanu, A.-C., Arb\u0103na\u0219i, E.-M., and Uivarosi, V. (2023). Overview of Side-Effects of Antibacterial Fluoroquinolones: New Drugs versus Old Drugs, a Step Forward in the Safety Profile?. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15030804"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1136\/adc.2010.208843","article-title":"Ciprofloxacin safety in paediatrics: A systematic review","volume":"96","author":"Adefurin","year":"2011","journal-title":"Arch. Dis. Child."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"25","DOI":"10.47577\/biochemmed.v4i1.8026","article-title":"Antibiotic resistance in urinary tract infection in children","volume":"4","author":"Goroftei","year":"2023","journal-title":"Tech. BioChemMed"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e26610","DOI":"10.5812\/ircmj.26610","article-title":"Bacterial uropathogens causing urinary tract infection and their resistance patterns among children in Turkey","volume":"18","author":"Yilmaz","year":"2016","journal-title":"Iran. Red Crescent Med. J."},{"key":"ref_44","first-page":"15","article-title":"Carbapenem resistance: Overview of the problem and future perspectives","volume":"3","author":"Meletis","year":"2016","journal-title":"Ther. Adv. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"4101","DOI":"10.2147\/IDR.S399442","article-title":"Prevalence, pathogenic bacterial profile and antimicrobial susceptibility pattern of urinary tract infection among children with congenital anomalies of the kidney and urinary tract","volume":"31","author":"Zhang","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Kawalec, A., Jozefiak, J., and Kilis-Pstrusinska, K. (2023). Urinary Tract Infection and Antimicrobial Resistance Patterns: 5-Year Experience in a Tertiary Pediatric Nephrology Center in the Southwestern Region of Poland. Antibiotics, 12.","DOI":"10.3390\/antibiotics12091454"},{"key":"ref_47","unstructured":"Clinical and Laboratory Standards Institute (CLSI) (2020). Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute. [30th ed.]. CLSI Supplement M100."},{"key":"ref_48","unstructured":"RC Team (2024, May 17). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. Available online: https:\/\/www.R-project.org\/."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Venables, W.N., and Ripley, B.D. (2002). Modern Applied Statistics with S, 4th ed, Springer. Available online: https:\/\/www.stats.ox.ac.uk\/pub\/MASS4\/.","DOI":"10.1007\/978-0-387-21706-2"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/8\/684\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:22:23Z","timestamp":1760109743000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/8\/684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,24]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["antibiotics13080684"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics13080684","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,24]]}}}