Pyelonephritis is a common pediatric infection with high risk of renal injury in children less than 5 years. Prompt diagnosis and treatment is mandatory to minimize the risk of renal scarring. To investigate the causative pathogen of pediatric pyelonephritis and to assess antibiotic resistance among these patients. The study conducted from the 1st of April 2019 to the 30th of December 2019 at Al-Diwaniya maternity and children teaching hospital and at outpatient clinic. Total number of patients involved were 130 children. We classified them in to two groups. Group 1(3 months -12 months) while Group 2 were (1-5 years old). Total number of patients involved in this study were 130 patients. 54 of them were (3-12 months) termed as group 1 and 76 of them (1-5 years) were group 2. From 130 urine samples, we get 186 bacterial isolate, majority was with one bacterial isolate (67.1%), multiple bacterial isolate also seen but in less number (32.9%). Regarding the causative bacterial pathogen. E. coli was the commonest microorganism isolated (73.07%), then Proteus mirabilis (16.92%), enterococcus (6.15%) and staphylococcus aureus (3.84%). On evaluating antibiotic sensitivity, we found that Imipenem , Nalidxic acid , Nitrofurantoin and Ciprofloxacin are highly sensitive antibiotics in vitro. Gentamycin show less sensitivity than amikacin. Cephalosporin, Penicillin and Trimethoprim-sulfamethoxazole show no valuable sensitivity (very high resistance).
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