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Research ArticleOriginal Article
Open Access

Patterns of antibiotic resistance in uropathogens isolated from pediatric patients

A multicenter study

Zeyad A. Almatroudi, Abdullah M. Almazrou, Abdullah H. Aljomoai, Zaid M. Alsulami, Abdulaziz M. Alotaibi, Abdulmohsen A. Almutairi, Aiman El-Saed, Faisal A. Alsehli and Majid M. Alshamrani
Saudi Medical Journal April 2025, 46 (4) 418-424; DOI: https://doi.org/10.15537/smj.2025.46.4.20241083
Zeyad A. Almatroudi
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
Roles: Medical Student
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  • ORCID record for Zeyad A. Almatroudi
  • For correspondence: [email protected]
Abdullah M. Almazrou
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
Roles: Medical Student
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Abdullah H. Aljomoai
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
Roles: Medical Student
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Zaid M. Alsulami
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
Roles: Medical Student
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Abdulaziz M. Alotaibi
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
Roles: Medical Student
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Abdulmohsen A. Almutairi
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
Roles: Medical Student
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Aiman El-Saed
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
MD, PhD
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Faisal A. Alsehli
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
PharmD, MSc
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Majid M. Alshamrani
From the College of Medicine (Almatroudi, Almazrou, Aljomoai, Alsulami, Alotaibi, Almutairi, Alsehli), King Saud bin Abdulaziz University for Health Sciences, from the Department of Neonatal Intensive Care (Alsehli); and from the Department of Infection Prevention and Control (El-Saed, Alshamrani), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
MD
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    Figure 1

    - Multidrug-resistant and extended-spectrum beta lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates, stratified by gender. MDR: multidrug-resistant, E. coli: Escherichia coli, K. pnemoniae: Klebsiella pneumoniae, ESBL: extended-spectrum beta lactamase

Tables

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    Table 1

    - Age distribution of patients, stratified by gender.

    Age groups (in years)Males (n=101)Females (n=509)P-values
    <147 (46.6)125 (24.6)<0.001
    1-527 (26.7)190 (37.3)0.042
    6-1527 (26.7)194 (38.1)0.029

    Values are presented as numbers and percentages (%).

      • View popup
      Table 2

      - Distribution of uropathogen species, stratified by gender.

      Species ↓MalesFemalesTotal by species
      Escherichia coli51 (50.5)421 (82.7)472 (77.4)
      Klebsiella species29 (28.7)53 (10.4)82 (13.4)
      Proteus mirabilis6 (5.9)15 (2.9)21 (3.4)
      Pseudomonas aeruginosa5 (4.9)4 (0.8)9 (1.5)
      Citrobacter koseri1 (1.0)4 (0.8)5 (0.8)
      Enterococcus species2 (2.0)4 (0.8)6 (0.9)
      Enterobacter cloacae4 (4.0)2 (0.4)6 (0.9)
      Salmonella species2 (2.0)2 (0.4)4 (0.7)
      Achromobacter xylosoxidans1 (1.0)0 (0.0)1 (0.2)
      MRSA0 (0.0)1 (0.2)1 (0.2)
      Myroides species0 (0.0)1 (0.2)1 (0.2)
      Acinetobacter baumannii0 (0.0)1 (0.2)1 (0.2)
      Streptococcus agalactiae0 (0.0)1 (0.2)1 (0.2)
      Total by gender101 (100)509 (100)610 (100)

      Values are presented as numbers and percentages (%).

      MRSA: Methicillin-resistant Staphylococcus aureus

        • View popup
        Table 3

        - Escherichia coli verses non-Escherichia coli isolates, stratified by gender (p<0.001).

        Species ↓Males (n=101)Females (n=509)
        E. coli51 (50.5)421 (82.7)
        Non-E. coli50 (49.5)88 (17.3)

        Values are presented as numbers and percentages (%).

        E. coli: Escherichia coli

          • View popup
          Table 4

          - Resistance patterns of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis isolates, stratified by gender.

          SpeciesAntibiotic ↓MalesFemalesP-values
          No. of isolates testedNon-susceptibleNo. of isolates testedNon-susceptible
          E. coliAmpicillin4133 (80.5)*324200 (61.7)0.018
          Ceftriaxone4617 (37.0)*41288 (21.4)0.016
          Ciprofloxacin4222 (52.4)*39893 (23.4)<0.001
          Imipenem170 (0.0)*880 (0.0)N/A
          Meropenem170 (0.0)*890 (0.0)N/A
          Nitrofurantoin421 (2.4)*40715 (3.7)0.664
          TZP80 (0.0)*543 (5.6)0.494
          TMP/SMX4421 (47.7)*412152 (36.9)0.159
          Gentamicin260 (0.0)*1229 (7.4)0.153
          Amox-clav92 (22.2)*6218 (29.0)0.671
          K. pneumoniaAmpicillin2525 (100)4949 (100)N/A
          Ceftriaxone2610 (38.5)479 (19.1)0.071
          Ciprofloxacin1910 (52.6)4313 (30.2)0.092
          Imipenem100 (0.0)90 (0.0)N/A
          Meropenem100 (0.0)90 (0.0)N/A
          Nitrofurantoin2013 (65.0)4427 (61.4)0.780
          TZP51 (20.0)40 (0.0)0.342
          TMP/SMX1914 (73.7)449 (20.4)<0.001
          Gentamicin211 (4.8)222 (9.1)0.577
          Amox-clav61 (16.7)61 (16.7)1
          P. mirabilisAmpicillin52 (40.0)136 (46.1)0.882
          Ceftriaxone61 (16.7)152 (13.3)0.865
          Ciprofloxacin61 (16.7)152 (13.3)0.865
          Imipenem10 (0.0)11 (100)0.386
          Meropenem20 (0.0)20 (0.0)N/A
          Nitrofurantoin66 (100)1515 (100)1
          TMP/SMX62 (33.3)154 (26.7)0.821
          Gentamicin40 (0.0)31 (33.3)0.286
          Amox-clav11 (100)31 (33.3)0.540

          Values are presented as numbers and percentages (%). *Non-susceptibility includes resistant and intermediate susceptibility isolates.

          E. coli: Escherichia coli, K. pneumoniae: Klebsiella pneumoniae, P. mirabilis: Proteus mirabilis, TZP: piperacillin-tazobactam,

          TMP/SMX: trimethoprim-sulfamethoxazole, Amox-clav: amoxicillin and clavulanate, N/A: not available

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          Saudi Medical Journal: 46 (4)
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          1 Apr 2025
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          Patterns of antibiotic resistance in uropathogens isolated from pediatric patients
          Zeyad A. Almatroudi, Abdullah M. Almazrou, Abdullah H. Aljomoai, Zaid M. Alsulami, Abdulaziz M. Alotaibi, Abdulmohsen A. Almutairi, Aiman El-Saed, Faisal A. Alsehli, Majid M. Alshamrani
          Saudi Medical Journal Apr 2025, 46 (4) 418-424; DOI: 10.15537/smj.2025.46.4.20241083

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          Patterns of antibiotic resistance in uropathogens isolated from pediatric patients
          Zeyad A. Almatroudi, Abdullah M. Almazrou, Abdullah H. Aljomoai, Zaid M. Alsulami, Abdulaziz M. Alotaibi, Abdulmohsen A. Almutairi, Aiman El-Saed, Faisal A. Alsehli, Majid M. Alshamrani
          Saudi Medical Journal Apr 2025, 46 (4) 418-424; DOI: 10.15537/smj.2025.46.4.20241083
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          Keywords

          • antibiotic resistance
          • multidrug-resistance
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          • pediatrics
          • extended-spectrum beta-lactamase

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