Frequency and susceptibility of bacteria caused urinary tract infection in neonates: eight-year study at neonatal division of Bahrami children's hospital, Tehran Iran

ABSTRACT

Susceptibility pattern of organisms causing urinary tract infection [UTI] in neonate would potentially improve the clinical management by enabling clinicians to choose most reasonable first line empirical antibiotics. This study aimed to this end by studying isolated organisms from neonates with UTI in an inpatient setting. Current retrospective study has recruited all cases of neonatal UTI diagnosed through a suprapubic/ catheterized sample, admitted to Neonatal Division of Bahrami Children's Hospital, Tehran, Iran, from June 2004 to June 2012. Escherichia coli was the dominant [64.4%] bacteria among a total of 73 cases [69.9% boys and 30.1% girls; aged 14.14 +/- 7.68 days; birth weight of 3055.85 +/- 623.00 g] and Enterobacter [19.2%], Klebsiella [12.3%], and Staphylococcus epidermdisis [4.1%] were less frequent isolated bacteria. E. coli was mostly resistant to ampicillin [93.6%], cefixime [85.7%] and cephalexin [77.3%], and sensitive to cefotaxime [63.6%]. Enterobacter found to be most resistant to amikacin [100%], ampicillin [92.85%], and most sensitive to ceftizoxime [71.4%]. A high ratio [> 92.85%] of resistance toward ampicillin was observed among common neonatal UTI bacterial agents. Having this finding along with previous reports of emerging resistance of neonatal uropathogens to ampicillin could be a notion that a combination of a third generation cephalosporin and an aminoglycoside would be a more reasonable first choice than ampicillin plus an aminoglycoside