Morganella morganii Urinary Tract Infection in Jordanian Children: Case Series from a Tertiary Hospital
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Background Urinary tract infections (UTIs) pose significant risks to children's health, with potential for kidney damage if untreated. Morganella morganii is an uncommon but important pathogen in pediatric UTIs. We aimed to describe the clinical characteristics, risk factors, and antibiotic susceptibility patterns of M. morganii UTIs in Jordanian children. Materials and Methods We conducted a retrospective review of pediatric patients (aged 0–18 years) diagnosed with M. morganii UTIs at King Abdullah University Hospital from 2017 to 2022. Data collected included demographics, clinical presentation, laboratory findings, imaging studies, antimicrobial susceptibility profiles, and treatment offered. Results Nine patients were identified, 77.8% of whom were female, with a median age of 3.35 years (interquartile range, 2-14.5). The most common symptoms were fever (55.6%), malodorous urine (44.4%), and vomiting (22.2%). A high prevalence of underlying urological abnormalities, particularly neurogenic bladder and myelomeningocele (44% each), was noted. Eight cases involved lower UTIs. M. morganii isolates were uniformly sensitive to amikacin, cefepime, and piperacillin-tazobactam but resistant to amoxicillin-clavulanate and nitrofurantoin. Conclusion M. morganii should be considered in pediatric UTIs, especially among children with urinary tract anomalies or catheter use. Awareness of its distinct resistance profile is critical for selecting appropriate empiric therapy.
Abstract
Background Urinary tract infections (UTIs) pose significant risks to children's health, with potential for kidney damage if untreated. Morganella morganii is an uncommon but important pathogen in pediatric UTIs. We aimed to describe the clinical characteristics, risk factors, and antibiotic susceptibility patterns of M. morganii UTIs in Jordanian children. Materials and Methods We conducted a retrospective review of pediatric patients (aged 0–18 years) diagnosed with M. morganii UTIs at King Abdullah University Hospital from 2017 to 2022. Data collected included demographics, clinical presentation, laboratory findings, imaging studies, antimicrobial susceptibility profiles, and treatment offered. Results Nine patients were identified, 77.8% of whom were female, with a median age of 3.35 years (interquartile range, 2-14.5). The most common symptoms were fever (55.6%), malodorous urine (44.4%), and vomiting (22.2%). A high prevalence of underlying urological abnormalities, particularly neurogenic bladder and myelomeningocele (44% each), was noted. Eight cases involved lower UTIs. M. morganii isolates were uniformly sensitive to amikacin, cefepime, and piperacillin-tazobactam but resistant to amoxicillin-clavulanate and nitrofurantoin. Conclusion M. morganii should be considered in pediatric UTIs, especially among children with urinary tract anomalies or catheter use. Awareness of its distinct resistance profile is critical for selecting appropriate empiric therapy.