en Microbiology Microbiology Original Research: Basic Science in Medicine Original Research: Basic Science in Medicine <div style="text-align: justify;"><span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">Urinary tract infection (UTI) is common after pediatric renal transplantation, and the emergence of multidrug-resistant (MDR) bacteria causing UTI is a therapeutic challenge in this regard. The main purpose of this study was to determine the UTI frequency, its etiologic agents, and the antibiotic susceptibility pattern in the first year following renal transplantation in Iranian pediatric recipients. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> In a retrospective cohort study, all of the 81 children who had undergone renal transplantation in Hazrat Rasoul Akram Hospital between 2012 and 2017 were enrolled. Confirmed episodes of UTI during the first year following renal transplantation were analyzed. The pattern of antibiotic resistance was determined for the causative agents of UTI. The data were analyzed using the IBM SPSS Statistics software (version 20). and the </span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> < 0.05 was considered significant.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> Totally, from 81 enrolled cases, 37(44.7%) cases were in the age group of 11-15 years. Overall, 19, 10, and 3 UTI episodes had occurred in the first month, from the first to sixth month, and between the sixth month and one year after transplantation, respectively. The four most common isolated bacteria were </span></span><span style="font-size:9.0pt">Escherichia coli</span><span style="font-size:9.0pt"><span style="font-style:normal"> (</span></span><span style="font-size:9.0pt">E. coli</span><span style="font-size:9.0pt"><span style="font-style:normal">; 31.2%), </span></span><span style="font-size:9.0pt">Pseudomonas aeruginosa</span><span style="font-size:9.0pt"><span style="font-style:normal"> (</span></span><span style="font-size:9.0pt">P. aeruginosa</span><span style="font-size:9.0pt"><span style="font-style:normal">; 25%), </span></span><span style="font-size:9.0pt">Enterococci </span><span style="font-size:9.0pt"><span style="font-style:normal">(21.9%) and </span></span><span style="font-size:9.0pt">Klebsiella pneumoniae</span><span style="font-size:9.0pt"><span style="font-style:normal"> (</span></span><span style="font-size:9.0pt">K. pneumoniae</span><span style="font-size:9.0pt"><span style="font-style:normal">; 12.5%). The highest rate of resistance was reported to trimethoprim/sulfamethoxazole (TMP/SMX), cephalosporins, and fluoroquinolones among gram-negative bacteria. However, none of the </span></span><span style="font-size:9.0pt">Enterococci</span><span style="font-size:9.0pt"><span style="font-style:normal"> isolates were resistant to linezolid and nitrofurantoin. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion:</b> Resistance to antibiotics is increasing among the pathogens causing UTI in pediatric renal transplanted cases. It is suggested to stop the administration of TMP/SMX and third-generation cephalosporins for empiric treatment of UTI in Iranian pediatric renal transplant recipients. Ciprofloxacin might be administered cautiously secondary to the increasing rate of antibiotic resistance in this group.</span></span></span></span></span></span></span></span><br> &nbsp;</div> <span style="font-size:11pt"><span style="line-height:200%"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="line-height:200%"><span style="font-family:"Times New Roman",serif"></span></span></span></span></span></span> Pediatrics, Renal transplantation, Urinary Tract Infection, Antimicrobial resistance 63 68 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-7528-1&slc_lang=en&sid=1 Shirin Sayyahfar Sayyahfar.sh@iums.ac.ir 200319475328460076167 200319475328460076167 No 1. Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Zahra Mohammadnezhad smohammadnezhad@yahoo.com 200319475328460076168 200319475328460076168 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Khosrow Zamani zamanikh@yahoo.com 200319475328460076169 200319475328460076169 No Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Rozita Hoseini rozitahoseini@yahoo.com 200319475328460076170 200319475328460076170 No Hazrat-e Ali Asghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Hasan Otukesh hasanotukesh@yahoo.com 200319475328460076171 200319475328460076171 No Hazrat-e Ali Asghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Nahid Rahimzadeh rahimzadeh.n@iums.ac.ir 200319475328460076172 200319475328460076172 Yes Hazrat-e Rasool General Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran