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Abstract

Introduction: Urinary tract infection (UTI) is one of the most common bacterial infections in pediatrics, with a wide spectrum of clinical manifestations, which can be the sentinel event for congenital anomalies of the urinary tract. Given its relevance in the emergency setting, representing up to 5%-10% of causes of fever of unknown origin, the aim was to characterize the process of urine sample collection and testing from patients suspected of UTI in a Pediatric Emergency Service (PES).
Methods: Retrospective review of urine cultures collected in the service between March 2020 and January 2024.
Results: A total of 745 urinary screenings were conducted, with a median age of 2.8 years, 60.7% of whom were female. Sample processing took an average of 1.3±0.6 days. The positivity rate in aseptic methods was 17.4%, ranging from 23% for midstream voiding to 50% for bladder puncture. Although Escherichia coli was the most frequent isolate (70.7%), it also exhibited one of the highest resistance rates to amoxicillin-clavulanic acid (33%). Other isolated germs were: Proteus at 20.7%, Staphylococcus saprophyticus at 2.3%, Klebsiella and Enterococcus at 1.5% each, and other germs at 2.3%. Resistance to cefuroxime was observed in 1.5%.
Conclusion: In this study, E. coli remains the predominant pathogen in UTI, and the increasing resistance to penicillins in our population is concerning. Cefuroxime is an effective option in empirical treatment of UTI.