Clinical Microbiology and Antimicrobial Chemotherapy. 2026; 28(1):103-107
To study structure of pathogens of community-acquired urinary tract infections (UTI) in children and adolescents under 18 years of age subpopulation of the Krasnoyarsk region as well as the activity of antimicrobials against the leading pathogen in order to optimize local empirical therapy of UTI.
A total of 298 urine cultures were analyzed (164 in 2023 and 134 – in 2024). The urinalyses were obtained from children and adolescents with community-acquired UTI who hospitalized to the Krasnoyarsk Regional Clinical Center for Maternal and Child Health in 2023–2024. The continuous observation method and retrospective analysis were used.
Escherichia coli was the leading etiological pathogen of community-acquired UTI in Krasnoyarsk region. Klebsiella pneumoniaе and Enterococcus spp. accounted in the 2-3 place in etiological structure. Of the parenteral agents, antimicrobial resistance of E. coli to meropenem was absent. The maximal sensitivity E. coli was noted for ampicillin-sulbactam and amikacin. Antimicrobial resistance of E. coli was recorded above 20% in relation to cefepim and 3-rd generation cephalosporins as to amoxicillin-clavulanate and cotrimaxozole. Of the oral medicines fosfomycin and nitrofurantoin activity to E. coli was preserved.
According to the data on antibacterial resistance of E. coli in children and adolescents with community-acquired UTI in the Krasnoyarsk region the starting drug of choice to empirical therapy of UTI in considered to be ampicillin-sulbactam for parenteral administration and fosfomycin or nitrofurantoin for oral prescription. 3-rd generation cephalosporins and amoxicillin-clavulanate cannot be recommended for empirical treatment due to the identified resistance level exceeding 20%.