Acute appendicitis is an infrequent condition in neonates, especially in term infants. With around 100 cases in the last century and no specific diagnostic tool, this case report is an addition to the existing literature that helps in our understanding of the disease. A preterm infant who had greenish aspirates and dilated bowel loops on abdominal x ray and was treated on the lines of necrotizing enterocolitis failed to improve. Baby had issues of abdominal distension whenever feeds were started hence exploratory laparotomy was done on the 45th day of life which showed appendicitis with adherent terminal ileum, caecum, and appendix. Two months after the surgery, the patient was unable to respond to antibiotic therapy for septic condition leading to death.
Objective: To determine etiology, sensitivity and resistance pattern of urinary tract infection in pediatrics age group 0 to 16 years at tertiary care hospital. Methodology: It was a cross-sectional study conducted inPediatric department of Aga khan university hospital and its affiliated secondary care centers in Karachi and Hyderabad. All urine culture proven children aged 0-16 years were included in the study. Urine culture showed growth of single pathogen and pathogen had more 10,000 colonies. Urine samples were obtained by SPA, clean catch, urinary catheter. Pre-designed proforma was used to note down the etiology and resistance pattern of urinary tract infection. SPSS version 25 was used to analyse data. Results: Of 177 patients, 70.1 % were females and 29.9% were males. Most common organism was E.coli 71.2% (n=126) followed by Klebsiella pneumonia 16.9% (n=30). Proteus Mirabilis 6.8% (n=12), and Pseudomonas aeruginosa 5.1% (n=9). Most common organism E.coli was 78% and 72.7% sensitive to nitrofurantoin and amikacin respectively and 85.1%, 91.4% and 77.3% resistance to ceftriaxone, ciprofloxacin and ampicillin respectively. This study will help in choosing choice of antibiotic on empirical basis for better outcome in resources limited setting like in remote areas and reduced financial burden on community. Conclusion: E.coli was the most common bacterial isolates among children with UTI. Nitrofurantoin and Amikacin showed higher sensitivity against E.coli., while Ciprofloxacin, Ceftriaxone and Ampicillin showed high resistance against E.coli. Keywords: Bacterial resistance, E.coli, urinary tract infection, paediatric population, antimicrobial sensitive
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