Introduction Urinary tract infections (UTIs) are the most common genitourinary disease and second most common infection in childhood. The aim of this study was to identify the most common bacteria causing UTIs, clinical manifestations and detection of antibiotic susceptibility of isolates in children under 18 years of age who were referred to the hospital in Hamadan, western Iran.
Methods A discriptive analytical study was performed on 456 patients who were suspected to have a UTI. Urine cultures, urine analysis, clinical manifestations and antibiotic susceptibility patterns were investigated. The required data from patients were gathered through a questionnaire and analyzed using the Epi6 system. An antibiogram for twelve antibiotics was performed by the gel-diffusion method of Kirby-Bauer.
Results Out of 456 children suspected to have a UTI, 156 children (34.2%) had positive bacterial culture with 88.5% of isolates Gram-negative. The most common isolates were Escherichia coli (58.4%), Enterobacter sp. (9.6%), Kelebsiella sp (6.4%), Staphylococcus aureus (5.8%) and Psuedomonas aeroginosa (5.1%). Fever (72.8%), dysuria (58.3%), flank pain (47.4%), urgency (43.6%) and urinary frequency (39.8%) were the commonest clinical manifestations of patients. The most effective antibiotics against isolates were nitrofurantoin, ciprofloxacin, naledixic acid, amikacin, ceftizoxime and co-trimoxazole, while most isolates showed high resistance to ampicillin, tobramycin, tetracyline and amoxicillin.
Conclusions This study showed that Gram-negative bacilli, in particular E. coli and Enterobacter sp., are predominant causes of bacterial agents of UTIs in children under 18 years of age in this region. Most species showed high resistance to routine antibiotics such as tobramycin, amoxicillin, ampicillin and tetracycline.