1423. Overview of Paediatric Urinary Tract Infections in the Gulf Co-operation Council (GCC) Countries, A Literature Review

Abstract Background Urinary tract infections (UTIs) are among the most frequent infections in the pediatric population, occasionally associated with concealed renal anomalies. Hence, early treatment is pertinent to reduce morbidities for better patient outcomes. The study aimed to review published literature from the gulf region in the last decade on UTIs etiology, common risk factors, current antimicrobial management, outcomes, and common resistance patterns. Methods This narrative literature review was conducted by evaluating articles published for a 10-years period from 2011 to 2021 using “Google Scholar” and “PubMed” databases. The search included regional clinical practice guidelines, systematic review and meta-analysis conducted across Gulf Cooperation Council countries (GCC). The search was limited to English literature and patients below 18 years old. Results The prevalence of UTIs among pediatrics in the age group of 0 to18 years ranged from 9.9% to 50.8% across the region. Data obtained from 11,092 children revealed that Escherichia coli was the primary cause of UTI (26% to 93.5%), followed by Klebsiella pneumoniae (3.8% to 76.4%). Furthermore, Extended-spectrum beta-lactamases (ESBLs) producing pathogens were observed in 7% to 35.2%. Higher ESBL rates were observed in patients with recurrent UTIs. Ampicillin and Co-trimoxazole, and 3rd generation cephalosporins were mainly prescribed as first-line antibiotics. Increased resistance to Ampicillin, Co-trimoxazole, and 3rd generation cephalosporins while low resistance to Nitrofurantoin, Amikacin, and Meropenem was documented. Vesicoureteral reflux was the most common risk factor for UTIs. Renal abnormalities were also observed to provide a nidus for bacterial growth. There is an evident lack of data in the region on antimicrobial treatment duration, possible predictors of treatment failure, and epidemiological data on multidrug resistance. Conclusion Urinary tract infections (UTIs) in pediatrics are a common therapeutic challenge in the region. Larger scale multicenter national and regional epidemiology studies are a prerequisite in the region. There is a need to monitor antimicrobial resistance in pediatrics & enhance surveillance for the advancement of management. Disclosures Nervana Habashy, B. Pharm, Pfizer (Employee) Ashraf Hassanien, MD, Pfizer (Employee) Ayman Kurdi, MD, Pfizer (Employee)