Antibiotic Sensitivity and Resistance Profile of E. Coli and Klebsiella Isolated from Urine of Pediatric Patients at a Tertiary Care Hospital in Bangladesh

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Background: Urinary tract infections (UTIs) are a common cause of morbidity among pediatric patients, with Escherichia coli (E. Coli) and Klebsiella spp. accounting for the majority of cases. The emergence of antimicrobial resistance, particularly multidrug-resistant (MDR) and extended-spectrum β-lactamase (ESBL)-producing strains, has significantly compromised the effectiveness of empirical treatment options. Continuous monitoring of local resistance patterns is therefore critical to inform antibiotic stewardship strategies and optimize clinical outcomes in pediatric care settings. Aim: This study aimed to determine the antibiotic sensitivity and resistance profiles of Escherichia coli and Klebsiella species isolated from urine samples of pediatric patients at a tertiary care hospital in Bangladesh. Methods: This cross-sectional study was conducted at the Department of Pediatric Nephrology, Bangladesh Medical University (BMU), Dhaka, Bangladesh from September 2024 to August 2025. A total of 230 pediatric patients aged 1 month to 18 years, presenting with clinical features suggestive of urinary tract infection (UTI) were included using a purposive sampling technique. Patients who had received antibiotics within the previous 48 hours or had known structural or congenital abnormalities of the urinary tract were excluded. Midstream urine samples were collected aseptically and cultured on Cysteine-Lactose-Electrolyte-Deficient (CLED) and MacConkey agar using the standard loop method. Significant bacteriuria was defined as a colony count of ≥10⁵ CFU/ml. Isolates of Escherichia coli and Klebsiella spp. were identified using standard biochemical methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion technique on Mueller-Hinton agar, and results were interpreted according to Clinical & Laboratory Standards Institute (CLSI) 2024 guidelines. Data were analyzed accordingly and compared with statistical tests. Results: Out of 230 pediat

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