Mahajan Simren, Kanwar Neena, Morgan Gina M, Mendes Rodrigo E, Lee Brian R, Banerjee Dithi, Selvarangan Rangaraj
School of Medicine, University of Missouri, Kansas City, MO 64108, USA.
Children's Mercy, Kansas City, MO 64108, USA.
Pathogens. 2024 Dec 6;13(12):1068. doi: 10.3390/pathogens13121068.
Urinary tract infections (UTIs) are among the most common pediatric infections. This study evaluated the antimicrobial susceptibility patterns of 3511 uropathogenic (UPEC) isolated from pediatric patients in the United States from 2014 to 2023. The database from the SENTRY antimicrobial surveillance program from 89 medical centers was utilized as a data source. The antimicrobial susceptibility was tested using the microbroth dilution technique against 24 antimicrobial agents. MICs were determined using the CLSI/EUCAST/FDA breakpoint criteria. All the antimicrobials reported susceptibility rates above 80% except for tetracycline (76.2%), trimethoprim-sulfamethoxazole (69.7%), and ampicillin-sulbactam (55.7%). During the study period, the susceptibility rates remained stable for most antimicrobial agents. However, significant differences were observed among age, gender, and U.S. census regions, with the Middle Atlantic showing the lowest and the Mountain region the highest susceptibility rates, for most antimicrobials. The incidence of ESBL UPEC increased from 7.1% to 10.8% between 2014 and 2023, while the prevalence of the MDR phenotype remained relatively stable. The prevalence of both ESBL and MDR phenotypes was highest among infants and young children (0-24 months), with the highest resistance rates from the Pacific region. Knowledge of the landscape of antibiotic resistance in pediatric UPEC will help healthcare providers to better tailor empiric treatment regimens for most UTI infections.
尿路感染（UTIs）是最常见的儿科感染之一。本研究评估了2014年至2023年从美国儿科患者中分离出的3511株尿路致病性大肠杆菌（UPEC）的抗菌药物敏感性模式。来自89个医疗中心的哨兵抗菌监测项目的数据库被用作数据源。采用微量肉汤稀释技术对24种抗菌药物进行抗菌药物敏感性测试。使用CLSI/EUCAST/FDA断点标准确定最低抑菌浓度（MICs）。除四环素（76.2%）、甲氧苄啶-磺胺甲恶唑（69.7%）和氨苄西林-舒巴坦（55.7%）外，所有抗菌药物的报告敏感率均高于80%。在研究期间，大多数抗菌药物的敏感率保持稳定。然而，在年龄、性别和美国人口普查区域之间观察到显著差异，对于大多数抗菌药物，大西洋中部地区的敏感率最低，山区的敏感率最高。2014年至2023年期间，产超广谱β-内酰胺酶（ESBL）的UPEC发生率从7.1%增至10.8%，而多重耐药（MDR）表型的流行率保持相对稳定。ESBL和MDR表型的流行率在婴幼儿（0 - 24个月）中最高，太平洋地区的耐药率最高。了解儿科UPEC中的抗生素耐药情况将有助于医疗保健提供者更好地为大多数UTI感染制定经验性治疗方案。
