Changes in Etiologic Agents and Escherichia coli Sensitivity to Antibacterial Treatment in Acute Pyelonephritis: 2010-2011 vs 2020-2021 at Lithuanian University of Health Sciences Kaunas Clinics Department of Children Diseases

Abstract

Aim: To evaluate the etiologic agents of acute pyelonephritis, their sensitivity to antibacterial treatment, and to assess changes in E. coli sensitivity to antibiotics. Methods: This retrospective study involved collecting medical history data from children diagnosed with acute pyelonephritis and treated at the LUHS Kaunas Clinics Department of Children's Diseases in 2020–2021 (n=270). The collected data were compared with those from 2010 – 2011, as published in the study by Atkočiūnas and coauthors titled “Acute pyelonephritis in children: etiology and antibiotic susceptibility”. Statistical analysis was conducted using the “IBM SPSS Statistics” program, employing the χ2 criterion, Mann-Whitney test, and Score test. Results were deemed statistically signifcant if p < 0.05. Results: In 2020–2021, 270 patients were diagnosed with acute pyelonephritis at LUHS Kaunas Clinics Department of Children diseases. Urine cultures were collected from 266 subjects, with signifcant positive results in 204 cases. Among these, E. coli was detected in 83.3 % and E. faecalis in 6.9 % of cases. The sensitivity of E. coli to antibiotics varied: ampicillin (50.3 %), cefuroxime (95.2 %), ciprofoxacin (94.6 %), gentamicin (95.8 %), nitrofurantoin (98.2 %), trimethoprim (79.6 %). E. faecalis showed 100 % sensitivity to ampicillin and nitrofurantoin. Additionally, in 2020–2021, E. faecalis was signifcantly more prevalent than in 2010–2011 (p < 0.001). In 2020–2021, the sensitivity of E. coli to cefuroxime in urine cultures signifcantly decreased compared to 2010–2011 (p < 0.001). Conclusion: Most cases of acute pyelonephritis were caused by E. coli, which exhibited high sensitivity to nitrofurantoin, gentamicin, and cefuroxime. Over the decade, the incidence of acute pyelonephritis caused by E. faecalis increased, and the sensitivity of E. coli to cefuroxime decreased.