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Ashraf M, Ahmed P, Ahmed Peer S, Suhail Lone M, Nisar Andrabi A, Mushtaq S. Clinico-bacteriological Profile, Antibiotic Resistance Pattern, in Recurrent Urinary Tract Infections In Children. J. Pediatr. Rev 2026; 14 (1) :73-80
URL: http://jpr.mazums.ac.ir/article-1-773-en.html

Background: Urinary tract infections (UTIs) are among the significant health concerns in children. In addition, recurrent UTIs pose a greater challenge with increasing rates of antibiotic resistance and acute kidney injury. 
Objectives: To study the clinical and bacterial profiles, resistance patterns, and associated risk factors for recurrent UTIs in the pediatric population. 
Methods: A prospective observational study over 18 months was conducted, during which 60 children aged 1 month to 18 years with recurrent UTIs were enrolled. Data on demographics, clinical presentation, underlying anomalies, bacterial isolates, and antibiotic susceptibility (antibiogram) and imaging results were recorded and analysed. 
Results: Of 60 patients, 35(58.3%) were female, and the mean age of the studied children was 4.88±3.99 years. The most common symptoms were fever in 42 patients (70%), abdominal pain in 40(66.7%), and dysuria in 25(41.7%). Congenital anomalies of the kidney and urinary tract (CAKUT) were present in 43 patients (71.7%), with vesicoureteral reflux in 27(45%) being the most prevalent. Bowel bladder dysfunction (BBD) was seen in 39(65%) enrolled patients. Urine culture grew gram-negative microorganisms in 46(76.7%); Escherichia coli was the most common, showing 100% sensitivity to nitrofurantoin and colistin but 100% resistance to ampicillin and cefotaxime. Gram-positive enterococci were isolated from 10/60 (16.6%) and showed 100% sensitivity to nitrofurantoin, vancomycin, and linezolid; however, they were 100% resistant to gentamicin. 
Conclusions: Children with underlying CAKUT and bowel dysfunction are predisposed to recurrent UTIs. E. coli and Enterococci are the most common uropathogens with concerning antibiotic resistance profiles. These findings highlight the need for targeted antibiotic stewardship and early management of BBD and CAKUT to prevent recurrence.