• Adnan M Hamawandi Department of Pediatrics, School of Medicine, Faculty of Medical Sciences, University of Sulaimani, Kurdistan Region, Iraq.
  • Sherko A Omer Department of Microbiology, School of Medicine, Faculty of Medical Sciences, University of Sulaimani, Kurdistan Region, Iraq.
  • Tara Hussain Tayib Department of Pediatrics, School of Medicine, Faculty of Medical Sciences, University of Sulaimani, Kurdistan Region, Iraq.
  • Mahammd Karim Mustafa Department of Pediatrics, Halabja General Hospital, Sharazor Health Directorate, Kurdistan Region, Iraq.



Urinary tract infection, Children, Antibacterial susceptibility, Sulaimani



Urinary tract infection is a common infection among children with recognized pathogens that can have different susceptibility to antibacterial agents in different communities. It is recognized as a cause of acute morbidity and chronic medical conditions.


The aim of this study was to identify the causative agents in pediatric urinary tract infection as well as the antimicrobial susceptibility of the isolated microorganisms.

Patients and Methods

A prospective study involved 86 pediatric patients suspected to have urinary tract infection. Physical examination and ultrasonographic examination were carried out. Urine samples were cultured, examined, and antimicrobial susceptibility was performed on bacterial isolates according to Kirby Bauer disk diffusion method.


Pyuria was found in 60 (70 %) of the urine samples. Twenty nine (39%) samples yielded a positive culture while 31 (61%) of pyuria samples yielded no growth. Seven (19%) urine samples showed no pyuria but yielded a positive culture. The most frequently isolated bacteria were Escherichia coli followed by Proteus mirabilis, and Klebsiella pneumoniae. All E. coli isolates were susceptible to nitrofurantoin while 22 (95.6%) isolates out of 23 were susceptible to amikacin and 78% of E. coli were susceptible to ceftriaxone, cefixime and ciprofloxacin. E. coli isolates were highly resistant to cotrimoxazole and amoxicillin.


Pediatric urinary tract infections are more common in females than males in all age groups and affect more preschool age group. Common uropathogens were E. coli which were commonly resistant to many commonly used antibiotics such as cotrimoxazole and amoxicillin, but were highly sensitive to nitrofurantoin and amikacin.


Santen SA, Altieri MF. Pediatric urinary tract infection. Emergency medicine clinics of North America. 2001;19(3):675-90. Epub 2001/09/14. DOI:

Marcdante KJ. Nephrology and Urology. In: Marcdante KJ, Kliegman RM, Jenson HB, Behrman RE, editors. Nelson Essentials of Pediatrics. 6th ed. Philadelphia: Elevier Saunders; 2010. p. 414-5.

Cleary TG. Urinary Tract Infection. In: Behrman RE, Kliegman RM, Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics 19th ed. Philadelphia: W.B. Saunder 2011. p. 1829-34.

Johnson JR. Microbial virulence determinants and the pathogenesis of urinary tract infection. Infectious disease clinics of North America. 2003;17(2):261-78, viii. Epub 2003/07/10. DOI:

Larcombe J. Urinary tract infection in children. BMJ. 1999;319(7218):1173-5. DOI:

Lum GM. Kidney & Urinary Tract. In: Hay WW, Deterding RR, Sondheimer JM, Levin M, editors. Current Diagnosis and Treatment of Pediatrics. 19th ed: McGraw-Hill; 2009. p. 670-72.

Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D’Amico F, et al. Does this child have a urinary tract infection? JAMA : the journal of the American Medical Association. 2007;298(24):2895-904. Epub 2007/12/27. DOI:

York MK. Urine Cultures. In: Isenburg HD, editor. Clinical Microbiology Procedures Handbook. 2 ed. Washington, D.C.: American Society for Microbiology; 2007. p. 3.12.1-3..31.

Schoreder J, Osyiw J, Challand G. Dry reagent chemistry techniques. In: Burnett D, Crocker J, editors. The Science of Laboratory Diagnosis 2ed. West Sussex, England: John Wiley & Son, Ltd; 2005. p. 417-28.

Matthai J, Ramaswamy M. Urinalysis in urinary tract infection. Indian journal of pediatrics. 1995;62(6):713-6. DOI:

Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966;45(4):493-6. DOI:

Gorelick MH, Shaw KN. Screening tests for urinary tract infection in children: A meta-analysis. Pediatrics. 1999;104(5):e54. DOI:

Al-Ma’amoory RJ, Alwan SJ, AlNaaimi AS, Al-Hadithi T, Sabri M. Validity of pyuria and bacteriuria (detected by Gram-stain) in predicting positive urine culture in asymptomatic female children. Iraqi J Comm Med. 2007;20(2):394-52.

Strasinger SK, Lorenzo MSD. Urinalysis and Body Fluids. United States of America: F. A. Davis Company; 2008.

Aboud MJ, Kadhim MM. The microorganism and underlying urological anomalies causing the urinary tract infection in the children attended the pediatric surgery clinic At the Maternity and Child Teaching Hospital Al-Qadisiya, Iraq. The New Iraqi Journal of Medicine. 2011;7(2):9-16.

Ullah Z, Khan MH, Akhta a, Zai S, Ahmad J. Urinary Tract Infection; An Old Disease In The New Age. The Professional. 2005;12(2):1-4.

Taneja N, Chatterjee SS, Singh M, Singh S, Sharma M. Pediatric urinary tract infections in a tertiary care center from north India. The Indian journal of medical research. 2010;131:101-5.18. Chan SP. Diagnostic Facilities in General Practice. Hong Kong Practitioner. 1989;11(4):2667-76.






How to Cite

Hamawandi A, Omer S, Tayib T, Mustafa M. ANTIBACTERIAL SUSCEPTIBILITY IN URINARY TRACT INFECTION AMONG CHILDREN IN SULAIMANI. JSMC [Internet]. 2015 Jun. 1 [cited 2024 Jul. 13];5(1):1-6. Available from:

Similar Articles

1-10 of 423

You may also start an advanced similarity search for this article.