# Current Trends in Antibiotic Resistance Patterns of Pathogens in Urinary Tract Infections in Children in Karaganda, Kazakhstan

## TL;DR

This study examines antibiotic resistance in urinary tract infections among children in Kazakhstan, finding higher resistance in older children.

## Contribution

The study provides updated antibiotic resistance patterns in pediatric UTIs in Karaganda, highlighting age-related trends.

## Key findings

- E. coli was the most common pathogen, with high resistance to amoxicillin and erythromycin.
- Multidrug resistance increased with age, from 28% in infants to 43% in older children.
- Imipenem, amikacin, and meropenem showed high effectiveness against E. coli.

## Abstract

Urinary tract infections (UTIs) are common in children and result in frequent hospitalization, creating a social and economic burden for parents and the healthcare system. This study analyzes the patterns of antibiotic resistance of dominant uropathogens and assesses the impact of patient age and sex on these patterns.

This retrospective cohort study was conducted in Karaganda, Kazakhstan, between 2017 and 2022. Antibiotic resistance was assessed in two age groups: 0-12 months (Group I) and 13-60 months (Group II). Standard microbiological methods were used to identify UTI pathogens, and antibiotic resistance patterns were determined using the Kirby-Bauer disk diffusion method.

Among the 519 isolates (68.1%) from 762 children, the most common pathogens were Escherichia coli (170, 32.7%), Enterococcus faecalis (80, 15.4%),
and Staphylococcus epidermidiss (46, 8.9%) in both age groups. Antimicrobial resistance in common pathogens in Groups I and II was
high for amoxicillin (33 isolates, 76.7% and 45 isolates, 73.8%) and erythromycin (14 isolates, 73.7% and five isolates, 55.5%). Imipenem (31 isolates, 94%), amikacin (45 isolates, 90%)
, and meropenem (47 isolates, 87%) were effective against E. coli, whereas ceftriaxone (31 isolates, 97%) was more active against Gram-positive cocci. 157 (34%) uropatogens
were resistant to multiple drugs, increasing with age 72: (28%) (Group I) and 85 (43%) (Group II).

The study demonstrated a progressive increase in the prevalence of multidrug-resistant uropathogens with age in the pediatric population. Periodic monitoring of uropathogens helps track the growth of multidrug-resistant strains.