Prevalence and Antibiotic Resistance Pattern of Escherichia coli Isolated from Urine Samples of Pediatric Outpatients with Underlying Medical Conditions from Pakistan
Abstract
Background: Urinary tract infections (UTIs) caused by Escherichia coli pose a significant health burden in children, particularly in those with underlying medical conditions. The emergence of antimicrobial resistance, including extended-spectrum β-lactamase (ESBL) production and multidrug resistance (MDR), complicates treatment strategies. Data on resistance patterns in this vulnerable population remain limited in low-income and middle-income countries.
Methods: To determine the prevalence and antibiotic resistance patterns of E. coli isolated from urine samples of pediatric outpatients (1-12 years old) with underlying medical conditions. This hospital-based cross-sectional study was conducted at the Pakistan Institute of Medical Sciences (January 2022-January 2023). Urine samples were collected from 941 pediatric outpatients with documented underlying conditions. E. coli were identified biochemically and molecularly. Antimicrobial susceptibility testing was performed using Kirby-Bauer disc diffusion, with ESBL screening and confirmation.
Results: E. coli was detected in 30.08% (283/941) of samples, which was significantly higher in females than in males (38.1%, p <0.001). ESBL production was detected in 30.4% (86/283) of the isolates and MDR isolates in 18.7% (53/283). The highest rates of resistance were observed against ampicillin (70.3%), cephalexin (60.1%), and trimethoprim-sulfamethoxazole (59.4%). Low resistance was noted to nitrofurantoin (2.8%) and amikacin (1.8%).…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.