Resistencia antimicrobiana en infecciones urinarias pediátricas: patrones de resistencia, desafíos terapéuticos y estrategias de optimización del tratamiento antibiótico

Vollständiger Abstract

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Introduction: Urinary tract infections (UTIs) are among the most common bacterial infections in children and are one of the leading causes of medical consultations, as well as antibiotic use and hospitalization; Various studies in recent years have shown an increase in antimicrobial resistance, particularly in pathogens such as E. coli, which has created challenges in empirical treatment and led to higher rates of treatment failure, as well as recurrent infections and long-term renal complications. Objective of the study: To analyze bacterial resistance in urinary tract infections in the pediatric population, identifying the most common microorganisms involved, as well as the factors associated with the development of the infection and the impact of diagnosis and treatment. Methodology: A narrative literature review was conducted using scientific articles published in databases such as Scopus, SciELO, Google Scholar, and PubMed. The review included original studies, as well as literature reviews and scientific articles related to pediatric urinary tract infections, antimicrobial resistance, treatment of children with urinary tract infections, and bacterial resistance mechanisms. Publications from the past 5 years with clinical and scientific relevance were selected. Key findings: It was found that Escherichia coli is the primary causative agent of UTIs in both the adult and pediatric populations. Furthermore, there has been a progressive increase in strains resistant to commonly used antibiotics such as ampicillin, trimethoprim/sulfamethoxazole, and cephalosporins—primarily third-generation cephalosporins. The production of extended-spectrum beta-lactamases (ESBLs) is one of the main mechanisms of resistance due to its ability to limit treatment options. Other associated factors include antibiotic use, recurrent infections, hospitalization, and congenital anomalies of the urinary tract. Conclusion: Antimicrobial resistance is a challenge in the management of pediatric urinary tract infections, and significant clinical repercussions have been demonstrated; therefore, microbiological surveillance, the rational use of antibiotics, and tailoring treatment to each patient’s specific circumstances are strategies that must be implemented to improve patient recovery and prognosis.