ORIGINALARTICLE

BACTERIOLOGICAL PATTERN OF URINARY TRACT INFECTION IN CHILDREN PRESENTING

TO PEDIATRIC DEPARTMENT OF MARDAN MEDICAL COMPLEX

Pakiza Naeem¹, Khalil Ahmad², Muhammad Qasim Khan³, Muhammad Shah¹, Kainat Pervez¹, Ulfat Raza¹

How to cite this article

ABSTRACT

OBJECTIVES

This study aimed to determine the bacteriological proﬁle and antibiotic

susceptibility of culture-conﬁrmed urinary tract infections among children

presenting to the Pediatric Department of Mardan Medical Complex.

METHODOLOGY

Naeem P, Ahmad K, Khan MQ, Shah

M, Pervez K, Raza U. Bacteriological

Pattern of Urinary Tract Infection in

Children Presenting to Pediatric

Department of Mardan Medical

Complex. J Gandhara Med Dent Sci.

2026;13(3):41-46.

This hospital-based cross-sectional study was conducted from April 2025 to

October 2025. A total of 109 children aged 1 month to 12 years with

clinically suspected urinary tract infection were enrolled through consecutive

sampling. Urine microscopy, nitrite testing, culture, bacterial identiﬁcation,

and Kirby-Bauer disc diﬀusion susceptibility testing were performed. Data

were analyzed using SPSS version 25. Frequencies, percentages, 95%

conﬁdence intervals, Chi-square/Fisher-Freeman-Halton exact test, Cramer's

V, and binary logistic regression were applied.

https://doi.org/10.37762/jgmds.13-3.911

Date of Submission: 13-04-2026

Date Revised:

05-05-2026

Date Acceptance: 22-05-2026

RESULTS

¹Trainee Medical Ofﬁcer, Department of

Pediatrics, Mardan Medical Complex,

Mardan

The mean age was 6.72 ± 3.43 years, and 67 children (61.5%) were female.

Urine culture was positive in 53 cases (48.6%; 95% CI: 39.4-57.9%). Among

culture-positive isolates, Staphylococcus spp. was most frequent, 11 (20.8%;

95% CI: 12.0-33.5%), followed by Enterococcus spp., 10 (18.9%), Proteus

spp., 9 (17.0%), Escherichia coli, 8 (15.1%), Klebsiella spp., 8 (15.1%), and

Pseudomonas spp. 7 (13.2%). Ceﬁxime showed the highest sensitivity (30;

56.6%). Amoxicillin and co-amoxiclav showed the highest resistance, 31

(58.5%) each. No independent predictor of culture positivity was identiﬁed on

logistic regression.

³Professor, Department of Pediatrics,

Mardan Medical Complex, Mardan

Correspondence

²Khalil Ahmad, Assistant Professor,

Department of Pediatrics, Mardan

Medical Complex, Mardan

CONCLUSION

+92-336-4274088

drkhalilqasmi@gmail.com

Culture conﬁrmation remains essential in suspected pediatric UTI. The

predominance of Staphylococcus spp. should be interpreted cautiously due to

possible contamination and lack of species-level conﬁrmation. Organism-

wise susceptibility surveillance is recommended.

KEYWORDS: Urinary Tract Infection, Children, Bacteriological Pattern,

Antibiotic Resistance, Pediatric UTI

INTRODUCTION

requires compatible clinical features, pyuria, and

Urinary tract infection (UTI) is one of the common significant growth of a recognized uropathogen on

bacterial infections in children and remains an urine culture. In clean-catch midstream urine,

important cause of pediatric morbidity. If not diagnosed significant bacteriuria is commonly deﬁned as growth

and treated appropriately, UTI may lead to recurrent of a single organism at ≥10⁵ CFU/mL, while lower

infection, renal scarring, hypertension, and long-term colony-count thresholds may be used for catheter-

renal impairment.¹Diagnosis in children can be collected specimens when supported by symptoms and

challenging because clinical features vary with age. pyuria.⁴This distinction is important because culture

Infants and younger children may present with non- positivity

without

symptoms

may

represent

specific symptoms such as fever, irritability, vomiting, asymptomatic bacteriuria, and mixed growth or low

and poor feeding, whereas older children more colony counts may indicate contamination rather than

commonly report dysuria, increased urinary frequency, true infection.^5,6The epidemiology of pediatric UTI

urgency, abdominal pain, or ﬂank discomfort. varies according to age and gender. During infancy,

Therefore, clinical suspicion should be supported by boys may have a relatively higher frequency of UTI,

urine microscopy and culture confirmation.^2,3For particularly in the presence of urinary tract anomalies.

diagnostic accuracy, pediatric UTIs should be In contrast, after infancy, girls are more commonly

diﬀerentiated from asymptomatic bacteriuria and affected due to anatomical factors, such as a shorter

sample contamination. A diagnosis of UTI generally urethra and the proximity of the urethral opening to the

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Bacteriological Pattern of Urinary Tract Infection in Children Presenting to Pediatric Department

perineum.^7,8These diﬀerences make age- and gender- enrolled using non-probability consecutive sampling.

specific assessment important in pediatric UTI All eligible children presenting to the outpatient

evaluation.⁹Escherichia coli remains the most department or admitted to the pediatric ward with

frequently reported uropathogen in children worldwide, suspected urinary tract infection (UTI) were included

followed by organisms such as Klebsiella spp., Proteus consecutively. Since this was an observational cross-

spp., Enterococcus spp., Pseudomonas spp., and sectional study, no randomization or blinding was

selected staphylococcal species.¹⁰However, organism performed. Children aged 1 month to 12 years with

distribution may vary by setting, prior antibiotic symptoms suggestive of UTI, including fever, dysuria,

exposure, urine collection technique, outpatient or urinary

frequency,

abdominal

pain,

vomiting,

inpatient status, and whether cases are uncomplicated, irritability, or poor feeding, were included. Both ﬁrst-

recurrent, or hospital-acquired. Therefore, local episode and recurrent suspected UTI cases were

bacteriological surveillance is necessary before enrolled. Exclusion criteria included recent antibiotic

recommending

empirical

antibiotic

therapy.¹¹use within 48-72 hours, congenital urinary tract

Antimicrobial resistance among pediatric uropathogens abnormalities,

chronic

kidney

disease,

severe

is increasing, particularly against commonly used malnutrition, immunodeﬁciency, immunosuppressive

antibiotics. This has important clinical implications therapy, and incomplete clinical or laboratory data.

because inappropriate empirical treatment may lead to Data were collected through a structured proforma

persistent infection, recurrence, prolonged hospital stay,

and increased healthcare costs. Culture

antimicrobial susceptibility testing are, therefore, findings, nitrite test results, culture ﬁndings, bacterial

documenting demographic information, presenting

and symptoms, previous UTI history, urine microscopy

essential for guiding appropriate therapy. Ceftriaxone is

a parenteral third-generation cephalosporin and should

not be described as an oral agent; oral options for

pediatric UTI may include ceﬁxime or other

isolates, and antimicrobial susceptibility patterns. UTI

diagnosis was based on compatible clinical features

supported by urine microscopy and signiﬁcant bacterial

growth on culture. Signiﬁcant bacteriuria was deﬁned

appropriate

antibiotics,

depending

local as ≥10⁵ CFU/mL for clean-catch specimens and ≥5 ×

susceptibility patterns.¹²In Pakistan, updated local data

regarding pediatric UTI pathogens and antibiotic

resistance patterns remain limited, especially from

tertiary-care hospitals in Khyber Pakhtunkhwa. Region-

specific evidence is needed to support rational

10⁴ CFU/mL for catheterized samples with pyuria and

symptoms. Contaminated samples with mixed growth

were excluded from organism-speciﬁc analysis. Urine

samples were collected before antibiotic administration

using

midstream clean-catch

catheterization

antibiotic use and improve clinical management. techniques, depending on the child's age and toileting

Therefore, this study was conducted to determine the

bacteriological proﬁle and antibiotic susceptibility of

urinary tract infections among children presenting to

the Pediatric Department of Mardan Medical Complex.

status. Samples were processed within two hours in the

microbiology laboratory. Routine microscopy assessed

pyuria and hematuria, while cultures were performed on

standard media under aerobic conditions. Organisms

were identiﬁed using Gram staining and biochemical

tests.

Antimicrobial

susceptibility

testing

was

METHODOLOGY

conducted using the Kirby–Bauer disc diffusion method

according to Clinical and Laboratory Standards Institute

guidelines. Data were analyzed using IBM SPSS

version 25. Quantitative variables were summarized as

The cross-sectional descriptive study was conducted in

the Department of Pediatrics at Mardan Medical

Complex over six months from April to October 2025.

Ethical approval was obtained from the Ethical mean ± SD, while categorical variables were presented

Committee of Bacha Khan Medical College (Ref No. as frequencies and percentages. Chi-square or Fisher-

504/BKMC dated 16-05-2024), and the study synopsis

was approved by the College of Physicians and

Surgeons Pakistan (Ref No. CPSP/REU/PED-2022-

028-7203 dated April 12, 2025). Written informed

consent was obtained from parents or legal guardians,

and conﬁdentiality of patient information was ensured

throughout the study. Sample size was calculated using

the WHO formula for a single population proportion,

assuming a 95% conﬁdence level (Z=1.96), an expected

prevalence of 50%, and a 9.5% margin of error,

Freeman-Halton exact tests, Cramer's V, and binary

logistic regression were applied, with p≤0.05

considered statistically signiﬁcant.

RESULTS

The study included 109 children with suspected urinary

tract infection. The mean age was 6.72 ± 3.43 years,

ranging from 1 to 12 years. Most children were in the

6–10 years age group, and 67 (61.5%) were female,

yielding a minimum sample of 106 participants. To compared to 42 (38.5%) male. Among the clinical

compensate for incomplete data, 109 children were

features, Abdominal pain (57 (52.3%) was the most

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Bacteriological Pattern of Urinary Tract Infection in Children Presenting to Pediatric Department

Table 5: Binary Logistic Regression for Predictors of Culture

frequent clinical feature, followed by dysuria 54

(49.5%), fever 53 (48.6%), and a previous history of

UTI 52 (47.7%). Non-speciﬁc symptoms such as poor

feeding and irritability were also commonly observed.

The Laboratory ﬁndings showed that Pyuria was

present in 63 (57.8%) and hematuria in 49 (45.0%)

children, while nitrite positivity was found in 45

(41.3%). Urine culture was positive in 53 of 109

children, giving a culture positivity rate of 48.6% (95%

CI: 39.4-57.9%).

Positivity, n = 109

Adjusted OR 95% CI for OR -value

Variable

1.068

2.532

1.879

1.349

2.476

Age

-0.052 0.950

0.844-

0.449-

0.383-

0.288-

0.497-

0.390

0.884

0.685

0.230

0.801

Gender

Fever

0.064

1.066

-0.165 0.848

-0.472 0.624

Dysuria

Increased urinary 0.103

1.109

frequency

2.168

1.731

3.523

1.831

2.005

Abdominal pain -0.004 0.996

0.458-

0.348-

0.992

0.536

0.264

0.607

0.787

Vomiting

Previous UTI

Pyuria

-0.253 0.776

0.457 1.579

0.215 0.806

0.708-

0.355

Nitrite positive -0.111 0.895

0.399-

Table 1: Distribution of Bacterial Isolates among Culture-Positive

Cases, n = 53

Note: Omnibus χ² = 4.491, df = 10, p = 0.923;

Nagelkerke R² = 0.054; Hosmer–Lemeshow χ² =

10.492, p = 0.232; overall classiﬁcation accuracy =

57.8%. AOR = adjusted odds ratio; CI = conﬁdence

interval. Culture positivity was coded as the outcome

variable. The model included age, gender, fever,

dysuria, urinary frequency, abdominal pain, vomiting,

previous UTI, pyuria, and nitrite test result.

Organism

Frequency n (%)

11 (20.8%)

10 (18.9%)

09 (17.0%)

08 (15.1%)

07 (13.2%)

53 (100.0%)

Staphylococcus spp.

Enterococcus spp.

Proteus spp.

Escherichia coli

Klebsiella spp.

Pseudomonas spp.

Total

Table 2: Antibiotic Susceptibility Pattern among Culture-Positive

Isolates, n = 53

Table 6: Antibiotic Resistance Pattern by Bacterial Isolate among

Culture-Positive Cases, n = 53

Antibiotic

Sensitive n (%)

22 (41.5%)

30 (56.6%)

26 (49.1%)

23 (43.4%)

26 (49.1%)

27 (50.9%)

Resistant n (%)

31 (58.5%)

23 (43.4%)

27 (50.9%)

30 (56.6%)

27 (50.9%)

26 (49.1%)

Orga n Amox Co-a Ceﬁxi Ceftri Cipro Nitro Genta Imipe

Amoxicillin

Co-amoxiclav

Ceﬁxime

Ceftriaxone

Ciproﬂoxacin

Nitrofurantoin

Gentamicin

Imipenem

nism

icillin moxic me R axone floxac furan micin nem R

lav R

in R toin R R

Esche 08 04(50. 04(50. 03(37. 05(62. 0337.5 04(50. 02(25. 06(75.

richia

coli

0) % 0) % 5%) 5%) %)

0%) 0%) 0%)

Entero 10 0660.0 05(50. 05(50. 07(70. 06(60. 01(10. 04(40. 08(80.

coccus

0%) 0%) 0%) 0%) 0%) 0%) 0%)

spp.

Klebsi 08 0450.0 05(62. 02(25. 03(37. 05(62. 03(37. 03(37. 03(37.

ellasp

5%) 0%) 5%) 5%) 5%) 5%) 5%)

Table 3: Association between Bacterial Isolate and Gender among

Culture-Positive Cases, n = 53

Proteu 09 07

sspp.

(33

(55

(44

(77

(44

(44.

(77

Organism

Female n (%)

06 (75.0%)

06 (60.0%)

06 (75.0%)

05 (55.6%)

03 (42.9%)

07 (63.6%)

Male n (%)

02 (25.0%)

04 (40.0%)

02 (25.0%)

04 (44.4%)

04 (57.1%)

04 (36.4%)

.8%) .3%) .6%) .4%) .8%) .8%) .4%) 4%)

Escherichia coli

Enterococcus spp.

Klebsiella spp.

Proteus spp.

Pseudomonas spp.

Staphylococcus spp.

Pseud 07 04(57 05(71 04(57 04(57 03(42 04(57 05(71 01(14.

omona

sspp.

Staphy11 06 (54 09 (81 04 (36 04 (36 06 (54 08 (72 09 (81 04 (36.

lococc

usspp.

.1%) .4%) .1%) .1%) .9%) .1%) .4%) 3%)

.5%) .8%) .4%) .4%) .5%) .7%) .8%) 4%)

Note: Pearson Chi-square showed no signiﬁcant

association between bacterial isolate and gender, χ² =

2.430, p = 0.787. Because 75.0% of expected cell

counts were below 5, the Fisher-Freeman-Halton exact

test was also applied and remained non-significant (p =

0.822). Cramer's V was 0.214, suggesting a weak

association.

Note: R = resistant. Percentages are calculated within

each organism group. Because the number of isolates in

each organism group was small, organism-wise

resistance patterns should be interpreted descriptively

and cautiously.

DISCUSSION

Table 4: Association between Culture Result and Pyuria, n = 109

Urinary tract infection (UTI) remains one of the most

common bacterial infections in children and is

associated with considerable morbidity when diagnosis

and treatment are delayed. In the present study, the

mean age of participants was 6.72 ± 3.43 years, with

the majority in the 6–10 years age group, and females

constituted 61.5% of the study population. These

Culture Result Pyuria Absent n (%)

Pyuria Present n (%)

34 (60.7%)

Negative

Positive

22 (39.3%)

24 (45.3%)

29 (54.7%)

Note: Pearson Chi-square test was applied. No

signiﬁcant association was observed between pyuria

and urine culture result, χ² = 0.402, p = 0.526. Cramer's

V = 0.061 indicates a very weak association.

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Bacteriological Pattern of Urinary Tract Infection in Children Presenting to Pediatric Department

findings

are

consistent

with

the

established was unavailable. Another important consideration is

infection. Catheterized urine

epidemiological pattern of pediatric UTI, where girls catheter-associated

are more frequently aﬀected after infancy because of specimens are frequently required in infants and non-

anatomical factors such as a shorter urethra and closer toilet-trained children to minimize contamination

proximity of the urethral opening to the perineum.^14,15compared with bag urine collection.²¹However,

However, because this was a hospital-based study hospitalized or catheter-exposed children may exhibit a

employing consecutive sampling, the observed diﬀerent microbiological profile compared with

demographic distribution should be interpreted as uncomplicated community-acquired UTI. Organisms

representative of children presenting to a tertiary-care such as Enterococcus spp., Pseudomonas spp., and

pediatric department rather than the true community staphylococcal isolates are more commonly associated

prevalence of pediatric UTI. The clinical manifestations with recurrent, catheter-associated, complicated, or

observed in this study included abdominal pain, hospital-acquired infections.²²Since the present study

dysuria, fever, urinary frequency, vomiting, irritability, did not fully stratify cases according to hospitalization

and poor feeding, highlighting the well-recognized status, catheter exposure, or community- versus

variability in pediatric UTI presentation. Older children hospital-acquired infection, the bacteriological ﬁndings

commonly present with urinary complaints such as should be interpreted descriptively and cautiously. The

dysuria and frequency, whereas infants and younger antimicrobial

susceptibility

pattern

demonstrated

children often exhibit non-speciﬁc symptoms including moderate sensitivity to several antibiotics. Ceﬁxime

fever, vomiting, irritability, and poor feeding.^16,17This showed the highest sensitivity among culture-positive

overlap in clinical presentation emphasizes the isolates, whereas amoxicillin and co-amoxiclav

importance of microbiological conﬁrmation, as reliance demonstrated the highest resistance rates. Similar

on symptoms alone may overestimate the actual resistance trends among pediatric uropathogens have

prevalence of UTI. In the present study, urine culture been documented in recent regional and international

was positive in 53 of 109 clinically suspected cases, studies.^23,24Organism-speciﬁc analysis further revealed

resulting in a culture positivity rate of 48.6% (95% CI: higher resistance of Proteus spp. to amoxicillin,

39.4%-57.9%). Therefore, the ﬁndings should be ciproﬂoxacin, and nitrofurantoin, while Staphylococcus

interpreted as bacteriological characteristics among spp. demonstrated increased resistance to co-amoxiclav

culture-confirmed cases rather than among all clinically and gentamicin. These observations underscore the

suspected pediatric UTIs. The bacteriological proﬁle clinical importance of organism-speciﬁc susceptibility

diﬀered from the conventional pattern described in reporting rather than relying solely on overall

most pediatric UTI literature, where Escherichia coli sensitivity percentages. However, because each

accounts for approximately 80–90% of infections.^18,19

bacterial group contained relatively few isolates, these

Among the 53 culture-positive cases, Staphylococcus

spp. was the most frequent isolate, accounting for 11

cases (20.8%; 95% CI: 12.0%-33.5%), followed by

Enterococcus spp. (18.9%), Proteus spp. (17.0%),

Escherichia coli (15.1%), Klebsiella spp. (15.1%), and

Pseudomonas spp. (13.2%). Nevertheless, these

findings should not be interpreted as evidence of a

changing global epidemiological trend in pediatric UTI,

where E. coli remains the predominant uropathogen.

Instead, the observed organism distribution may reﬂect

local hospital-based sampling, recurrent infections,

findings should be regarded as descriptive rather than

deﬁnitive. Imipenem resistance deserves particular

attention. Resistance was observed in 26 of 53 isolates

(49.1%), suggesting hospital exposure, complicated

infection, prior antibiotic use, or the presence of

multidrug-resistant organisms.^6,25Nevertheless, the

absence of MIC testing, MDR classiﬁcation, molecular

resistance analysis, and infection stratiﬁcation limits

definitive interpretation. Statistical analysis further

demonstrated no signiﬁcant association between

bacterial isolate and gender, with Fisher-Freeman-

Halton exact testing remaining non-significant and

Cramer's V indicating only a weak association (0.214).

Similarly, pyuria was not signiﬁcantly associated with

culture positivity, suggesting that urine microscopy

alone may not reliably diﬀerentiate culture-confirmed

UTI cases. Binary logistic regression also failed to

identify any independent predictor of culture positivity

among assessed clinical and laboratory variables.

Overall, these ﬁndings reinforce the importance of

urine culture, contamination control, and regular

antimicrobial surveillance in guiding empirical therapy

for pediatric UTIs.

antibiotic

exposure,

catheter-collected

The

specimens,

or possible

contamination.

predominance of Staphylococcus spp. particularly

warrants cautious interpretation because certain

staphylococcal species, such as Staphylococcus

saprophyticus, may represent true uropathogens,

whereas coagulase-negative staphylococci can also

indicate contamination if collection technique, pyuria,

colony count, and clinical correlation are not adequately

assessed.²⁰Although contaminated samples with mixed

growth or insigniﬁcant colony counts were excluded,

species-level conﬁrmation of all staphylococcal isolates

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Bacteriological Pattern of Urinary Tract Infection in Children Presenting to Pediatric Department

Alsaywid BS, Alyami FA, Alqarni N, Neel KF, Almaddah TO,

LIMITATIONS

Abdulhaq NM, et al. Urinary tract infection in children: a

narrative review of clinical practice guidelines. Urol Ann.

Outpatient and inpatient cases, ﬁrst-episode and

recurrent UTIs, catheterized and clean-catch samples,

and community- versus hospital-acquired infections

were not analyzed separately. Furthermore, species-

level conﬁrmation of all staphylococcal isolates, MIC-

based susceptibility testing, MDR classiﬁcation, and

molecular resistance analysis were unavailable.

Severely malnourished and immunocompromised

children were also excluded, limiting applicability to

high-risk pediatric populations.

2023;15(2):97–105.

PMID: 37025734.

https://doi.org/10.4103/UA.UA_103_22

Bhargava K, Nath G, Bhargava A, Kumari R, Aseri GK, Jain N.

Bacterial proﬁle and antibiotic susceptibility pattern of

uropathogens causing urinary tract infection in Northern India.

Front

Microbiol.

2022;13:965053.

https://doi.org/10.3389/fmicb.2022.965053 PMID: 36248584.

Islam MA, Islam MR, Khan R, Amin MB, Rahman M, Hossain

MI, et al. Prevalence, etiology and antibiotic resistance patterns

of community-acquired urinary tract infections in Dhaka,

Bangladesh.

PLoS

One.

2022;17(9):e0274423.

https://doi.org/10.1371/journal.pone.0274423 PMID: 36099577.

Schmider J, Bühler N, Mkwatta H, Lechleiter A, Mlaganile T,

Utzinger J, et al. Microbiological characterisation of

community-acquired urinary tract infections in Bagamoyo,

CONCLUSIONS

Tanzania.

Trop

Med

Infect

Dis.

2022;7(6):100.

https://doi.org/10.3390/tropicalmed7060100 PMID: 35736674.

Kumar V, Singh RKN, Verma PK, Bhat NK, Shrivastava Y,

Yhoshu E, et al. Clinico-microbiological proﬁle and predictors

of urinary tract infection in children: a single-center study from

Nearly half of clinically suspected pediatric UTI cases

were culture positive. Staphylococcus spp. was the

most frequent isolate, followed by Enterococcus spp.,

Proteus spp., Escherichia coli, Klebsiella spp., and

Pseudomonas spp.; however, the predominance of

Staphylococcus spp. should be interpreted cautiously

because species-level conﬁrmation and detailed

contamination assessment were limited. Antibiotic

resistance patterns varied among organisms, while

imipenem resistance was reported descriptively due to

the absence of MIC testing, MDR classiﬁcation, and

hospital-acquired infection stratiﬁcation. These ﬁndings

emphasize the importance of routine urine culture,

cautious interpretation of gram-positive isolates,

reporting of organism-specific susceptibilities, and

regular local antimicrobial surveillance to guide

empirical treatment of pediatric UTI.

Himalayan

foothills.

Cureus.

2023;15(1):e33289.

https://doi.org/10.7759/cureus.33289 PMID: 36761438.

10. Silva A, Costa E, Freitas A, Almeida A. Revisiting frequency

and antimicrobial resistance patterns of bacteria implicated in

community urinary tract infections. Antibiotics (Basel).

2022;11(6):768.

PMID: 35740206.

https://doi.org/10.3390/antibiotics11060768

11. Rahme D, Nakkash Chmaisse H, Salameh P. Factors

inﬂuencing hospital stay in patients with urinary tract infections

and

microbial

susceptibility.

Antibiotics

(Basel).

2025;14(4):421. https://doi.org/10.3390/antibiotics14040421

12. Fayyaz A, Khan S, Arshad R, Abbas A, Batool N, Rasheed S.

Prevalence of urinary tract infection in malnourished children

aged 1 month to 5 years. J Islam Int Med Coll. 2025;20(3):201–

6. https://doi.org/10.57234/jiimc

13. Soomro T, Tikmani SS. Prevalence, etiology and predictors of

urinary tract infections in febrile children under ﬁve years.

Infect Dis J Pak. 2016;25(2):35–9.

14. Nelson Z, Aslan AT, Beahm NP, Blyth M, Cappiello M, Casaus

D, et al. Guidelines for prevention, diagnosis, and management

of urinary tract infections in pediatrics and adults:

WikiGuidelines consensus statement. JAMA Netw Open.

2024;7(11):e2444495.

CONFLICT OF INTEREST: None

FUNDING SOURCES: None

REFERENCES

https://doi.org/10.1001/jamanetworkopen.2024.44495 PMID:

39531952.

15. Stanciu OO, Andriescu M, Moga A, Caragata R, Balanescu L,

Balanescu R. Antibiotic resistance trends in recurrent paediatric

urinary tract infections: ﬁve-year single-centre experience.

Mekonnen S, Tesfa T, Shume T, Tebeje F, Urgesa K,

Weldegebreal F. Bacterial proﬁle, antibiotic susceptibility

pattern, and associated factors of urinary tract infections in

children at Hiwot Fana Specialized University Hospital, Eastern

Children

(Basel).

2025;12(11):1567.

https://doi.org/10.3390/children12111567 (PMID pending)

Ethiopia.

PLoS

One.

2023;18(4):e0283637.

16. Maringhini S, Alaygut D, Corrado C. Urinary tract infection in

https://doi.org/10.1371/journal.pone.0283637 PMID: 37030836.

Huang L, Huang C, Yan Y, Sun L, Li H. Urinary tract infection

etiological proﬁles and antibiotic resistance patterns among

diﬀerent age groups: a retrospective study. Front Microbiol.

children:

2024;12(11):2582.

up-to-date

review.

Biomedicines.

https://doi.org/10.3390/biomedicines12112582

39598014.

PMID:

2022;12:813145.

PMID: 35173652.

https://doi.org/10.3389/fmicb.2021.813145

17. Amleh T, Salah A, Hamayel R, Ibrahim BA, Sayeh H,

Hamshari S, et al. Bacterial etiology and antimicrobial

resistance patterns of pediatric urinary tract infections in

Ait-Mimoune N, Hassaine H, Boulanoir M. Bacteriological

proﬁle of urinary tract infections and antibiotic susceptibility of

Escherichia coli in Algeria. Iran J Microbiol. 2022;14(2):156–

60. https://doi.org/10.18502/ijm.v14i2.9180 PMID: 35509731.

Brandström P, Hansson S. Urinary tract infection in children.

Palestine.

BMC

Pediatr.

2025;25(1):725.

https://doi.org/10.1186/s12887-025-06054-0 (PMID pending)

18. Tullus K, Shaikh N. Urinary tract infections in children. Lancet.

2020;395(10237):1659–68.

https://doi.org/10.1016/S0140-

Pediatr

Clin

North

Am.

2022;69(6):1099–114.

6736(20)30676-0 PMID: 32334608.

https://doi.org/10.1016/j.pcl.2022.07.003 PMID: 36343654.

July - September 2026

J Gandhara Med Dent Sci

Bacteriological Pattern of Urinary Tract Infection in Children Presenting to Pediatric Department

19. Ehlers S, Merrill SA. Staphylococcus saprophyticus infection.

AUTHORS CONTRIBUTION

Treasure Island (FL): StatPearls Publishing; 2026. Available

from: https://www.ncbi.nlm.nih.gov/books/NBK482367/ PMID:

29494058.

Pakiza Naeem - Concept & Design; Data Acquisition; Data

Analysis/Interpretation;

Revision; Final Approval

Drafting

Manuscript;

Critical

20. Consensus guidelines for management of pediatric urinary tract

infection (UTI). Echo Res Pract. 2025;11. (DOI/PMID not

indexed)

Khalil Ahmad - Concept & Design; Data Acquisition; Data

Analysis/Interpretation;

Revision; Final Approval

Muhammad Qasim Khan

Drafting

Manuscript;

Critical

21. Werneburg GT. Catheter-associated urinary tract infections:

current challenges and future prospects. Res Rep Urol.

2022;14:109–33. https://doi.org/10.2147/RRU.S273663 PMID:

35308508.

Concept

Design; Data

Acquisition;

Data

Analysis/Interpretation;

Drafting

Manuscript; Critical Revision; Supervision; Final Approval

Muhammad Shah - Concept & Design; Data Acquisition; Data

22. Park PG, Lim SH, Song JY, Ahn YH, Kim SH, Kang HG.

Trends in antibiotic resistance of urinary tract infections in

young children, 2010–2023. Pediatr Neonatol. 2026;67(1):32–

Analysis/Interpretation;

Revision; Final Approval

Drafting

Manuscript;

Critical

Kainat Pervez - Concept & Design; Data Acquisition; Data

https://doi.org/10.1016/j.pedneo.2025.03.006

(PMID

Analysis/Interpretation;

Revision; Final Approval

Drafting

Manuscript;

Critical

pending)

23. Mareș C, Petca RC, Popescu RI, Petca A, Mulțescu R, Bulai

CA, et al. Update on urinary tract infection antibiotic resistance

in females: retrospective study. Life (Basel). 2024;14(1):106.

https://doi.org/10.3390/life14010106 PMID: 38255833.

Ulfat Raza - Concept & Design; Data Acquisition; Data

Analysis/Interpretation;

Revision; Final Approval

Drafting

Manuscript;

Critical

The authors accept responsibility for all aspects of the work

and will ensure that any concerns regarding the accuracy or

integrity of any part are properly investigated and resolved.

24. Mir SS, Ali E, Alghamdi SA, Alghamdi NM, Alharbi RA, Sindi

AAA, et al. Antimicrobial resistance in urinary tract infections

among patients with and without renal comorbidities in Saudi

Arabia.

Pathogens.

2025;14(12):1297.

https://doi.org/10.3390/pathogens14121297.

25. Que AT, Tran AD, Trang THN, Tran TNL, Bui NN, Lai CH.

Epidemiology and antimicrobial resistance patterns of urinary

tract infection in Vietnam: ﬁve-year cross-sectional study. Ther

Adv

Infect

Dis.

2025;12:20499361251315346.

https://doi.org/10.1177/20499361251315346

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July - September 2026

J Gandhara Med Dent Sci