Epidemiological profile of urinary tract infections in children before and during the COVID-19 pandemic: an observational study.

OBJECTIVE: The aim of this study was to evaluate whether the COVID-19 pandemic influenced the epidemiological, microbiological, and antimicrobial resistance profiles of urinary tract infections (UTI) in children admitted to a pediatric service. METHODS: This retrospective ecological study included patients under 12 years of age admitted to a Brazilian university hospital with a diagnosis of UTI based on clinical and laboratory criteria. Two periods were analyzed: 2018-2019 (pre-pandemic) and 2022-2023 (pandemic period). RESULTS: A total of 8007 urine cultures were analyzed, of which 203 met criteria for UTI (128 in the first and 75 in the second period). A higher proportion of neonates was observed in the second period. Escherichia coli remained the predominant pathogen. Klebsiella pneumoniae showed an increase in frequency (p=0.02) and resistance (p<0.001), while Pseudomonas aeruginosa also increased in frequency (p=0.02) and resistance (p=0.01). The susceptibility profile of other pathogens remained stable, with persistently high sensitivity to amikacin, meropenem, and third-generation cephalosporins. CONCLUSIONS: The COVID-19 pandemic period was associated with changes in the epidemiological and microbiological profile of pediatric UTIs. The increased frequency of healthcare-associated pathogens highlights the importance of continuous microbiological surveillance and rational antimicrobial use in pediatric practice.