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Category: Volume 07 Issue 02 February 2019
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Title: Study of pediatric uropathogens and their antimicrobial susceptibility pattern in a tertiary care hospital of eastern India

Authors: Dr Priyanka Saha, Dr Soma Mondal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.185

Abstract

Urinary Tract Infection (UTI) is one of the most common childhood bacterial infection. Early diagnosis, adequate therapy and prolonged follow-up are utmost important to reduce morbidity and long-term complications like renal scarring, hypertension, and chronic renal failure.

Objective: The study was carried out to find out the prevalent uropathogens causing pediatric UTI and their antibiotic susceptibility pattern.

Method: A total 728 urine specimens from children aged 0-12 years were processed in a tertiary care hospital from November 2015 to June 2016 . All bacterial isolates were identified by biochemical test and antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion test. Result:  Prevalence of urinary tract infection was found to be 15.52% among the study population. Overall it was more common in female child. E. coli was the commonest bacteria (45.13%) isolated, followed by Enterococcus spp (31.85%), Klebsiella pneumonia (8.84%), Staphylococcus aureus (3.5%), Candida spp (3.5%), Staphylococcus saprophyticus  (2.6%), Proteus vulgaris (1.76%), Pseudomonas spp (1.76 %), Morganella morganii (0.8%). Most of the oral antibiotics like cotrimoxazole, amoxyclav, ciprofloxacin, cefixime were highly resistant to urinary isolates. Nitrofurantoin was found to be the most sensitive (>65%) drug. Gram negative bacteria also showed high sensitivity to meropenem (71.22%) whereas linezolid (100%) and vancomycin were most sensitive drug for gram positive cocci (>90%)).

Conclusion: Antibiotic resistance has now become a big problem therefore it is an important issue need to be urgently addressed by the policy makers to formulate a strict antibiotics prescription policy in our country.

Keywords:  Paediatric, UTI,  Antibiotic sensitivity.

References

  1. Zorc JJ, Kiddoo DA, Shaw KN. Diagnosis and Management of Pediatric Urinary Tract Infections. Clin Microbiol Reviews2005; 18(2):417–422.
  2. Echeverri CV, Serna-Higuita LM, Serrano AK ,Ochoa-García C, Rosas LR, Bedoya AM, et al. Resistance profile for pathogens causing urinary tract infection in a pediatric population, and antibiotic treatment response, at a University Hospital 2010-2011. Colomb Med 2014; 45(1):39
  3. Grabe M, Bartoletti R, Bjerklund JTE, Guidelines on Urological Infections. EAU 2015.
  4. Habib S. Highlights for management of a child with a urinary tract infection. Int J Pediatr2012;2012:1-6.
  5. Hoberman A, Chao HP, Keller DM, Hickey R, Davis HW, Ellis D. Prevalence of uninary tract infection in febrile infants. J pediatr 1993; 123 : 17-23.
  6. Ayazi P, Mahyar A, Hashemi HJ, Khabiri S. Urinary Tract Infections in Children. Iranian JPediatrSoc2010; 2(1):9-14.
  7. Bryce A, Hay AD, Lane IF, Thornton HV, Wootton M, Costelloe C. Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics inprimary care: systematic review and metaanalysis. BMJ2016; 352:i939;doi.org/910.1136/bmj.i1939.
  8. Edlin RS, Copp HL. Antibiotic resistance inpediatric urology. TherAdvUrol2014; 6(2):54-61: DOI: 10.1177/1756287213511508.
  9. Shaikh N, Morone NE, Bost JE, Farrell MH.Prevalence of Urinary Tract Infection inChildhood A Meta-Analysis. Pediatr Infect Dis J2008; 27:302-308
  10. Forbes AB, Sahm FD, Weissfeld SA. Bailey and Scotts Diagnostic Microbiology. 12th ed. St Louis: Mosby; 2007. p. 850‑.
  11. Collee JG. Laboratory strategy in the diagnosis of infection syndromes: Mackie and McCartney: Practical Medical Microbiology. 14th ed.London, UK: Churchill Livingstone Elsevier; 2006. p. 87‑
  12. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 26th CLSI supplement M100S January 2016.
  13. Dash M, Padhi S, Mohanty I, Panda P, Parida B. Antimicrobial resistance in pathogens causing urinary tract infections in a rural community of Odisha, India. J Family Community Med 2013;20:20‑
  14. Mehta M, Bhardwaj S, Sharma J. Screening of urinary isolates for the prevalence and antimicrobial susceptibility of enterobacteria other than Escherichia coli. Int J Life Sci Pharma Res 2013;3:100‑
  15. Mohanty S, Kapil A, Das BK, Dhawan B. Antimicrobial resistance profile of nosocomial uropathogens in a tertiary care hospital. Indian J Med Sci 2003;57:148‑
  16. S. Prevalence and Antimicrobial Sensitivity Pattern of Urinary Tract Infection in Febrile Children Aged 1 Month to 5 Years IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)2013;10:15‑18
  17. Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community acquired urinary tract infections in JNMC Hospital, Aligarh, India. Ann Clin Microbiol Antimicrob 2007;6:6.
  18. Sood S, Gupta R. Antibiotic resistance pattern of community acquired uropathogens at a tertiary care hospital in Jaipur, Rajasthan. Indian J Community Med Nov 2012;19;37:39-44
  19. Pal N, Rit K, Naskar S, Kumar S, Guhathakurata R. A study of bacteriological and antibiotic susceptibility profile of pediatric urinary tract infection with special emphasis on extended spectrum beta‑lactamase production in a tertiary care hospital of Eastern India. International Journal of Health & Allied Sciences. 2016;5:259–62
  20. Cunha BA. New uses for older antibiotics: nitrofurantoin, amikacin, colistin, polymyxin B, doxycycline, and minocycline revisited. Med Clin North Am2006; 90:1089-1107.

Corresponding Author

Dr Soma Mondal

Associate Professor, College of Medicine and JNM hospital, W.B.U.H.S, Kalyani, Nadia

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