Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Trends in antibiotic susceptibility in childhood acute urinary tract infections: a single-center comparison across a 10-year interval in Korea

  • Erica Yim (Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine) ;
  • Kyeong Seob Shin (Department of Laboratory Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine) ;
  • Joon Kee Lee (Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine) ;
  • Tae-Sun Ha (Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine)
  • Received : 2026.01.20
  • Accepted : 2026.04.07
  • Published : 2026.06.30
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Abstract

Purpose: Acute urinary tract infection (UTI) is one of the most common bacterial infections in children and a major cause of antibiotic use. Increasing antimicrobial resistance has raised concerns regarding the appropriate selection of empirical antibiotics in pediatric UTIs. Methods: We retrospectively analyzed 571 children diagnosed with culture-confirmed acute UTI at a single tertiary center between 2015 and 2020 and compared the findings with data from a previous study conducted at the same institution between 2003 and 2008. Uropathogen distribution, antibiotic susceptibility patterns, extended-spectrum β-lactamase (ESBL) prevalence, and imaging findings were evaluated. Results: Gram-negative organisms accounted for 98.2% of UTIs, with Escherichia coli being the most common pathogen (89.1%). Compared with 2003-2008, antibiotic susceptibility significantly decreased during 2015-2020 for several commonly used agents in both the overall bacterial population and E. coli isolates. The prevalence of ESBL-producing organisms increased markedly. No significant association was observed between microbiological findings and imaging abnormalities. Conclusions: Antibiotic resistance in pediatric UTIs increased significantly over an approximately 10-year period within the same institutional setting. These findings highlight evolving antimicrobial resistance and underscore the importance of continuous local surveillance to guide empirical antibiotic selection.

Keywords

Acknowledgement

This work was supported by funding for the academic research program of Chungbuk National University in 2025.

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