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RESEARCH ARTICLE

Comparative analysis of urinary antibiograms in community pediatric and geriatric populations in British Columbia, Canada

Roxanna S. D. Mohammed1 ,  Eugene Y. H. Yeung2,3,4*
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1 Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V6H 3N1, Canada
2 Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
3 Continuing Pharmacy Professional Development, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
4 School of Medicine, Simon Fraser University, Surrey, British Columbia V3T 0A3, Canada
Bladder, e21200059 https://doi.org/10.14440/bladder.2025.0014
Submitted: 28 February 2025 | Revised: 23 June 2025 | Accepted: 9 July 2025 | Published: 6 October 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: The Clinical and Laboratory Standards Institute (CLSI) recommends the development of enhanced antibiograms specifically for elderly patients (≥65 years) to address the needs of long-term care facilities and to account for the anatomical sites from which specimens are collected, thereby facilitating antimicrobial stewardship. Similarly, the Canadian Pediatric Society advocates developing local, age-specific antibiograms to guide antimicrobial selection for targeted infections. Objective: This study aimed to develop antibiograms based on uropathogens identified at LifeLabs in British Columbia (BC), Canada. Methods: Urinary specimens from pediatric (<18 years) and geriatric (≥65 years) patients were collected and processed at LifeLabs, a community laboratory network comprising 129 collection centers across BC, between October 1, 2023, and September 30, 2024. Urinary antibiograms for both groups were developed in accordance with CLSI guidelines. Results: Among the 13,870 pediatric specimens, the most common uropathogen was Escherichia coli (13.7%), followed by Enterococcus faecalis (2.0%), Proteus mirabilis (1.1%), Streptococcus agalactiae (0.9%), Staphylococcus saprophyticus (0.9%), and Klebsiella pneumoniae (0.5%). Among the 148,480 geriatric specimens, the most common uropathogen was E. coli (17.1%), followed by E. faecalis (3.6%), K. pneumoniae (3.4%), S. agalactiae (2.0%), P. mirabilis (1.3%), and Pseudomonas aeruginosa (0.8%). Among the routine antimicrobials tested, ciprofloxacin consistently demonstrated significantly different susceptibility rates (p<0.05) between the pediatric and geriatric groups: E. faecalis (96.3% vs. 81.4%), E. coli (73.7% vs. 67.3%), and P. mirabilis (92.6% vs. 84.8%). Conclusion: The distribution of common uropathogens and their susceptibilities differed between pediatric and geriatric groups, supporting the need for age-specific antibiograms in community settings. Ciprofloxacin demonstrated lower susceptibility to the predominant uropathogens in elderly patients. Community antimicrobial stewardship teams should acknowledge these differences to better prioritize interventions tailored to each age group.

Keywords
Geriatrics
Pediatrics
Urine culture
Antibiogram
Antimicrobial susceptibility testing
Ciprofloxacin
Funding
None.
Conflict of interest
Eugene Y. H. Yeung is working as a microbiologist, physician, pharmacist, and clinical assistant professor. The views and opinions expressed are those of the authors and do not necessarily reflect the views or positions of their employers.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific
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