Antibiotic Resistance Patterns of Bacterial Isolates in Urine Samples of Paediatric Patients Collected at Diagnostic Laboratory Services in Bulawayo 2019-2023: A Trend Analysis.

Abstract

Antibiotic resistance represents a significant global health challenge, particularly in managing urinary tract infections (UTIs) among children, where the emergence of resistant strains complicates treatment and increases the risk of adverse outcomes. This study investigates the antibiotic resistance patterns of bacterial isolates from urine samples of paediatric patients at Diagnostic Laboratory Services in Bulawayo, spanning the years 2019 to 2023.A retrospective analysis was conducted, utilizing data collected from urine cultures to evaluate temporal trends in antibiotic susceptibility and resistance. A total of 120 paediatric patients were included in the study, with an emphasis on demographic factors such as age and gender that may influence resistance patterns.Results indicated a high prevalence of UTIs, particularly in the 0 to 3 years age group, which accounted for 40% of total cases. The dominant pathogen identified was E. coli, isolated in approximately 29.2% of samples, followed by Klebsiella spp. at 25.8%. Notably, antibiotic resistance patterns revealed significant fluctuations over the study period. Imipenem consistently exhibited 0% resistance, while resistance to ciprofloxacin decreased markedly from 42.9% in 2019 to 10% in 2023. Similarly, nitrofurantoin resistance decreased from 26.3% to 0%, reflecting improved susceptibility rates. Conversely, cotrimoxazole and ceftriaxone showed concerning resistance trends, with ceftriaxone resistance peaking at 100% in 2022.The analysis highlighted the presence of multidrug-resistant organisms, indicating a growing challenge in effectively treating paediatric UTIs. Factors such as male un-circumcision and a history of previous UTIs were identified as significant risk factors. These findings underscore the necessity for continuous surveillance of antibiotic resistance trends to inform treatment decisions and guide clinical practice. In conclusion, this study provides critical insights into the changing landscape of antibiotic resistance in paediatric UTIs, emphasizing the need for robust antibiotic stewardship programs and targeted educational initiatives for healthcare providers. Future research should focus on understanding the underlying mechanisms driving antibiotic resistance and the development of effective prevention strategies.