Uropathogens, antimicrobial resistance, and factors associated with resistance in community-onset urinary tract infections among Latin American children under five: a systematic review

Abstract

Pediatric urinary tract infections (UTIs) require etiologic and antimicrobial-resistance findings to be interpreted in relation to age, episode origin, and the denominators used. This systematic review synthesized evidence published between 2020 and October 5, 2026 on uropathogens, antimicrobial resistance, and resistance-associated factors in community-onset UTIs among Latin American children aged 0–59 months. Study identification followed a structured and traceable documentary process based on visible records from PubMed/PMC, SciELO, and BVS/LILACS, supplemented by publisher websites, repositories, and searches by title, DOI, country, and sensitivity. The documented flow comprised 43 unique candidate publications: 10 were excluded during initial screening, 33 contained sufficient information for detailed assessment, and four contributed usable information. Escherichia coli was the predominant uropathogen in the Paraguayan, Chilean, and Brazilian series. Evidence on susceptibility, ESBLs, and associated factors was sparse, heterogeneous, and limited to local settings. No meta-analysis was conducted; the available data do not support regional estimates or therapeutic recommendations.