Antibiotic sensitivity pattern of pathogens in children with urinary tract infection in a tertiary care hospital in Kachchh, Gujarat, India

Abstract

Background: This prospective observational study was conducted in a tertiary care hospital in Kachchh, over a period of 6 months, to know the antibiotic sensitivity pattern of pathogens in children less than 18 years old with Urinary Tract Infection (UTI). Methods: Between December 2016 to June 2017, 186 children met the inclusion criterion. Urine samples were collected and processed for urine routine microscopy, culture and antibiotic sensitivity as per the standard laboratory guidelines. Urine culture was positive in 50 cases, which were further evaluated to find out any renal disease. All patients were given 10-14 days antibiotics course and follow-up urine reports were done. Patients were considered cured when the follow-up urine reports were normal. Results: E. coli was the commonest organism (34%) isolated, found mainly in 1-5 years age group (20%). Enterococci were isolated in 32% cases, most of which were less than 5 years of age (28%). Klebsiella (12%), Methicillin Resistant Staphylococcus Aureus (MRSA) (10%), Coagulase negative staphylococci (6%), Pseudomonas (2%) and Budding yeast cell (4%) were the less frequent organisms isolated. E. coli were found to be less sensitive to different Aminoglycosides (11.7% -23.5%), Cephalosporins (11.7% -52.9%), Fluoroquinolones (5.8% -11.7%), Cotrimoxazole (17.6%) and Piperacillin (17.6%), but were more sensitive (70.6%) to Imipenems. Enterococci were also partially sensitive to Aminoglycosides (6.2-18.7%), Cephalosporins (25-37.5.7%), Fluoroquinolones (6.25-12.5%), Penicillin-G (50%), Piperacillin (31.25%) and Co-trimoxazole (43.75%), but had good sensitivity for Imipenems (68.7%), Linezolid (75%) and Vancomycin (81.2%). Similarly, MRSA was 100% sensitive to Linezolid and Imipenem but partially sensitive (20-60%) to other antibiotics. Klebsiella showed 16.65-33.3% sensitivity to all antibiotics except Imipenem (83.3%) and was 100% resistant to Co-trimoxazole. Coagulase negative Staphylococci (CONS) remained 100% sensitive to all antibiotics and Pseudomonas was resistant to all antibiotics. Conclusions: The study concludes that pathogens for UTI in children have developed resistance, even to the newer generation antibiotics, probably due to the irrational use of antibiotics. In view of emergence of multi drug resistant pathogens, which carry considerable morbidity and mortality, every effort must be taken to use antibiotics judiciously.

Prevalence of urinary tract infection and sensitivity pattern amongst children less than 3 years of age with fever in a tertiary care hospital in South Karnataka

“…A similar study done by Thaddanee et al, shows a 10% prevalence of MRSA in their study. 20 Other organisms like Enterococci showed a prevalence of 11.4%, which was similar to a study done by Badhan et al, which showed a prevalence of 13.5%. 16 In our study Klebsiella was isolated in only 5% of our cases.…”

“…16 In our study Klebsiella was isolated in only 5% of our cases. In contrast, Klebsiella was present in 12% of the cases in a study done by Thaddanee et al 20 This variation in species isolated probably be due to the regional variation (geographical and ethnical).…”

“…11,16 But our study showed least resistance to amikacin and nitrofurantoin similar to another study. 20,23 MRSA shows high sensitivity to vancomycin and linezolid, each 80% respectively and 60% sensitivity to nitrofurantoin and gentamicin each. A similar study, also says that MRSA is 100% sensitive to linezolid and 40 % sensitive to aminoglycosides.…”

“…Also, not so common pathogens could also emerge as causative organisms. 3 In almost all cases of suspected UTI infection, empirical therapy (mostly a broad-spectrum antibiotic) will be initiated before the definitive diagnosis of the pathogen. This empirical therapy keeps changing rapidly due to the emergence of resistance and needs to be updated regularly through regular sensitivity studies.…”

A retrospective study on prevalence, bacteriological profile and antibiotic sensitivity pattern of urinary tract infection in children of 2-12 years age in a tertiary care centre, Puducherry, India

“…9-10 Culture positive rate was 15.7%,26.8% and 18.3%in other studies by Kaur, Thaddenee and Patwardhan respectively. [11][12][13] This wide difference may be due to infant being the major contributor of culture positive UTI in Kaur study and we have taken only from 2-12 years age group. Males were predominant in our study in both age groups which may explain gender preference of health seeking behaviour.…”