Background and Objectives: Urinary tract infections (UTIs) are common in children and account for 5–6% of febrile illnesses. This study aims to evaluate the bacterial pathogens isolated from pediatric UTI cases and their antibiotic resistance patterns to inform updated treatment guidelines. Materials and Methods: This retrospective study included 2753 children with positive urine cultures treated at Adıyaman Training and Research Hospital from January 2020 to June 2024. Data on patient demographics, bacterial culture results, and antibiotic resistance patterns were analyzed. Results: Among the 2753 patients, 71.1% were female and 28.9% were male, with a mean age of 54.6 ± 48.6 months. Escherichia coli was the predominant pathogen, isolated in 61.2% of cases, followed by Klebsiella pneumoniae (13.3%), Proteus mirabilis (9.1%), and Enterococcus faecalis (3.5%). Gender-specific differences showed that E. coli was more frequently isolated in females (71.7%), while Proteus was more common in males (18.5%). Antibiotic resistance analysis revealed high resistance rates to ampicillin (67.4% in E. coli and 100% in Klebsiella), TMP-SMX (33.2% in E. coli and 30% in Klebsiella), and cefixime (45.3% in E. coli). Amikacin showed the lowest resistance across all pathogens, with only 0.9% resistance in E. coli. The resistance to third-generation cephalosporins, particularly ceftriaxone and cefixime, has significantly increased over time, especially in the Klebsiella species. Conclusions: The results indicate high resistance to ampicillin and TMP-SMX. However, E. coli and other pathogens remain susceptible to nitrofurantoin, amikacin, and carbapenems, making these antibiotics viable for empirical therapy. Regional resistance should be considered when selecting treatments for pediatric UTIs to improve outcomes and reduce resistance development.
Large-scale public health disruptions, including pandemics and natural disasters, may influence healthcare delivery, pathogen distribution, and antimicrobial resistance (AMR). This retrospective multicenter study evaluated uropathogen profiles and temporal trends in antibacterial resistance among hospitalized pediatric patients with urinary tract infections (UTIs) across periods corresponding to the COVID-19 pandemic, the February 6, 2023 Kahramanmaraş earthquakes, and the post-earthquake phase in heavily affected regions of Türkiye. Hospitalized pediatric patients (0–18 years) with culture-confirmed UTIs admitted between January 2020 and December 2024 to three tertiary care hospitals were included. Pathogen identification and antibacterial susceptibility testing were performed using standard microbiological methods in accordance with EUCAST criteria. Uropathogen distribution and resistance patterns were compared across predefined study periods. A total of 1131 pediatric patients were analyzed, of whom 54.29% were female. Gram-negative bacteria predominated (89.57%), with Escherichia coli (59.86%) and Klebsiella spp. (18.92%) being the most frequently isolated pathogens. Across the study periods, E. coli demonstrated significant increases in resistance to ampicillin (63.26% to 81.90%), ceftriaxone (41.99% to 53.76%), ceftazidime (39.46% to 63.10%), and trimethoprim–sulfamethoxazole (32.27% to 40.34%) (all p < 0.01). Among Klebsiella spp., a significant temporal increase was observed only for imipenem resistance, which rose from 18.64% during the COVID-19 period to 37.50% during the earthquake period before declining to 13.21% in the post-earthquake period ( p = 0.021). Multidrug-resistant (MDR) phenotypes were predominantly detected among Gram-negative organisms, with the highest proportions observed in Serratia spp., Citrobacter spp., Enterobacter spp., and Pseudomonas spp., while MDR prevalence in E. coli was comparatively lower. Temporal variations in antibacterial resistance were observed among pediatric UTI pathogens during periods of major public health disruption. These findings highlight the importance of sustained regional surveillance and context-aware empiric treatment strategies in settings exposed to systemic healthcare stressors.
13 September 2023 in Environmental Monitoring and Assessment
Objectives: While earthquakes impact the future expectations of entire societies, adolescents bear a hefty burden due to their transitional stage of life and the intricacies of adolescence itself. Our study examined the factors influencing the future expectations of adolescents residing in the region six months after the earthquake. Methods: A face-to-face survey was conducted involving 385 individuals aged 11 to 17 affected by the February 6 earthquake in Turkey. The survey included sociodemographic inquiries, questions regarding earthquake experiences, and the administration of the Future Expectation scale to all participants. Results: Participants who lost their family members, who were trapped under the debris, and whose family members were trapped under the debris had significantly lower future expectations. Moreover, happier individuals, who perceived themselves as healthier and more socialized, had significantly higher future expectations. Female individuals had significantly lower future expectations in all subdimensions of the scale. Lastly, adolescents who changed their career aspirations post-earthquake exhibited higher scores in all subdimensions of the scale compared to those who did not undergo such changes. Conclusions: Adolescents confronted with traumatic events like earthquakes, particularly those who have lost relatives, often experience a negative impact on their future expectations. However, during subsequent phases, adolescents who report happiness, improved health, and increased socialization tend to harbor more positive outlooks for the future. This underscores the significance of implementing psychosocial rehabilitation efforts following earthquakes.