Bacterial and Fungal Profile, Antibiotic Susceptibility Patterns of Bacterial Pathogens and Associated Risk Factors of Urinary Tract Infection Among Symptomatic Pediatrics Patients Attending St. Paul’s Hospital Millennium Medical College: A Cross-Sectional Study

Abstract

Background Urinary tract infection is a common infection in pediatrics. Understanding the common etiology of urinary tract infections, their antimicrobial susceptibility pattern, and associated risk factors in a particular setting can provide evidence for the appropriate treatment of the cases. Purpose The current study is aimed to determine the common etiology and prevalence of uropathogens associated with urinary tract infection, as well as the antibiotic susceptibility profile of bacterial isolates, and to identify risk factors associated with urinary tract infection among pediatric patients. Materials and Methods The study was conducted at St. Paul Hospital Millennium Medical College between October 2019 and July 2020. Urine was collected aseptically from patients, inoculated onto culture media, and incubated at 37 °C for 18–48 hours. Bacteria and yeast were identified following standard procedures. Antibiotic susceptibility testing of bacterial pathogens was carried out by the Kirby Bauer disc diffusion method. Descriptive statistics and logistical regressions were used to estimate the crude ratio with a 95% confidence interval. P-value < 0.05 was considered significant. Results Significant bacterial/fungal growth was observed in 65 samples giving a prevalence of 28.6% of which 75.4% (49/65) and 24.6% (16/65) were bacterial and fungal pathogens, respectively. About 79.6% of bacterial etiology were Escherichia coli and Klebsiella pneumoniae . The highest resistance was observed against ampicillin (100%), cefazolin (92.1%), and trimethoprim-sulfamethoxazole (84.1%), both of which are commonly used for empirical treatment in Ethiopia. Length of hospital stay (P=0.01) and catheterization (P=0.04) were statistically associated with urinary tract infection. Conclusion The high prevalence of urinary tract infection was observed in our study. Enterobacteriaceae were the major cause of urinary tract infection. Length of hospital stay and catheterization were significantly associated with urinary tract infection. Both Gram-negative and Gram-positive bacteria were extremely resistant to ampicillin and trimethoprim-sulfamethoxazole.

Nitrofuran Derivatives Cross-Resistance Evidence—Uropathogenic Escherichia coli Nitrofurantoin and Furazidin In Vitro Susceptibility Testing

“… Overview of data on Escherichia coli urine isolates nitrofurantoin resistance in the 21st century worldwide reports [ 2 , 7 , 8 , 10 , 13 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. …”

“…Pseudomonas spp., Acinetobacter spp.) is significantly increasing [ 1 , 11 , 12 , 13 ]. Gram-positive bacteria are much less likely to be the etiological factor of UTI–bacteria of the genus Enterococcus are most often identified, the share of which in HAI is more than twice as high as in CAI.…”

“…Staphylococcus aureus and other coagulase-negative staphylococci (with the predominance of Staphylococcus saprophyticus ) are also visible in the statistics of the etiology of UTI. A summary of the most common etiology of UTI depending on the source of infection (CAI vs. HAI) is presented in Table 1 [ 1 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 15 , 16 , 17 , 18 ]. Some analyses [ 6 , 18 , 19 , 20 ] also indicated a significant percentage (1–11%) of Streptococcus agalactiae among the Gram-positive etiological factors of UTI; however, due to limited reports (and a lack of information on healthcare or community sources), they are not included in Table 1 .…”

“…Figure 1 summarizes the resistance rate to nitrofurantoin among strains of E. coli causing UTI. The results come from studies performed in different regions of the world, in different periods, and in groups of different sizes [ 2 , 7 , 8 , 10 , 13 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. In most cases, the percentage of resistance to nitrofurantoin was low and often did not exceed 3%.…”

Non-Standardized Terminology in Healthcare: Shortcomings and Subsequent Rectifications [Letter]

“…We have read the study titled “Bacterial and Fungal Profile, Antibiotic Susceptibility Patterns of Bacterial Pathogens and Associated Risk Factors of Urinary Tract Infection Among Symptomatic Pediatrics Patients Attending St. Paul’s Hospital Millennium Medical College: A Cross-Sectional Study” with an interest to know about bacterial and fungal isolates causing urinary tract infections (UTI) in symptomatic pediatric patients. 1 …”