A Study of Bacteriological Profile and Antibiotic Susceptibility Patterns Among Culture Positive Urinary Tract Infection in Febrile Children

Abstract

BACKGROUNDChildren of any age with febrile Urinary tract infection (UTI) can have acute pyelonephritis and subsequent renal scarring. UTI should be treated promptly to prevent possible progression to pyelonephritis. UTI may be suspected based on symptoms or findings on urinalysis or both. Urine culture sensitivity testing is necessary for confirmation and appropriate therapy. Aims and Objectives-The primary aim of the study was to evaluate bacteriological profile and their antibiotic culture sensitivity pattern in culture positive UTI in febrile children. MATERIALS AND METHODSThis cross-sectional study was conducted at outpatient clinics of our "Child Health Clinics" between May 2016 and April 2017 (One year). All children aged 0 to 12 years whose urine cultures were positive while evaluating for a febrile illness with suspected UTI were included in the study to evaluate the bacteriological profile and their culture sensitivity patterns. RESULTSSixty nine (69) children with culture positive UTI were enrolled in this study in 1-year period. The most common organism isolated in our study was E. coli (Escherichia coli) 39/ 69 (56.5%) followed by Klebsiella (17.4%), Pseudomonas (13%), Proteus (8.7%) and Staphylococcus aureus (4.4%). Majority of the Gram negative isolates of our study were found sensitive (100%) to broad-spectrum antibiotics such as Imipenem, Meropenem and Tigecycline. Next to them Cefoperazone + Sulbactam was the most effective antibiotic against all four gram negative isolates of our study. The only gram positive isolate of our study, i.e. Staphylococcus aureus was found sensitive (100% -3/3) to Cefepime, Cefotaxime, Ceftriaxone, Vancomycin, Linezolid, Azithromycin and Clarithromycin. CONCLUSIONUrinary tract infection should be considered as one of the differential diagnosis of fever in children. Escherichia coli is the most common organism causing UTI in children. As resistance to first line antibiotics is increasing, the paediatricians should appreciate the need for urine culture and sensitivity as a part of standard evaluation of febrile children and also, they should monitor the antimicrobial culture sensitivity patterns to choose the appropriate antibiotics to treat the febrile UTI in children to prevent longterm complications.