Bacterial profile, antibiotic susceptibility pattern and associated risk factors of urinary tract infection among clinically suspected children attending at Felege-Hiwot comprehensive and specialized hospital, Northwest Ethiopia. A prospective study

Abstract

Background Urinary tract infection is one of the most common bacterial infections in children. Understanding the characteristics of uropathogens and their antimicrobial susceptibility pattern in a particular setting can provide evidence for the appropriate management of cases. This study aimed to assess the bacterial profile of urinary tract infection, their antimicrobial susceptibility pattern and associated factors among clinically suspected children attending at Felege-Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted from February–April, 2019. A systematic sampling technique was employed. A mid-stream urine sample was inoculated on cystine lactose electrolyte deficient media and incubated for 24–48 h. Sub-culturing was done on Mac-Conkey and blood agar. Antimicrobial susceptibility test was done on Muller-Hinton agar. A binary logistic regression model was used to see the association between dependent and independent factors. A p-value< 0.05 at 95% CI was considered as statistically significant. Results The overall prevalence of urinary tract infection was 16.7% (95% CI 12.4–21.1). Both Gram-negative and Gram-positive bacterial isolates were recovered with a rate of 44/50 (88%) and 6/50 (12%) respectively. Among Gram-negative isolates, E. coli 28/44(63.6%) was predominant while S. saprophyticus 2/6(33.3%) was prevalent among Gram-positive bacterial isolates. Overall, a high level of resistance to ampicillin, augmentin, and tetracycline was shown by Gram-negative bacteria with a rate of 44/44(100%), 39/44(88.6%), and36/44 (81.8%) respectively. About 33/50(66%) of overall multidrug resistance was observed (95% CI 52–78). About six Gram-negative bacterial isolates were extended spectrum beta-lactamase (ESBL) producers. Having a history of urinary tract infection (P-0.003, AOR 1.86–22.15) and male uncircumcision (p-0.00, AOR 5.5–65.35) were the independent variables that associate for urinary tract infections. Conclusion In the present study, the prevalence of urinary tract infection among children was high and considerably a high proportion of multidrug resistance was observed. This result will have a significant impact on the selection of appropriate antimicrobial agents for the treatment of urinary tract infection.

Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute

“…Among the isolated gram-positive bacteria, Staphylococcus aureus represents high drug resistance. This finding is consistent with studies conducted in Saudi Arabia [36], Ethiopia [35] and Iraq [31].…”

“…According to this study, E. coli is the main urinary tract pathogen, which is consistent with almost all similar investigations [35,36,40]. This is due to the existence of many virulence factors dedicated to colonization and invasion of the urinary epithelium.…”

“…The highest age-specific prevalence was found in the 21-30-year-old age group 73 (22.5%), which is consistent with other studies, showing that sexually active groups, especially women, are more likely to develop urinary tract infections [35,36]. This study is consistent with the studies recorded in India [2] and Ethiopia [36].…”

“…The reason for the lower relative prevalence in this study could be that the patient was treated with antibiotics before arriving at the institute for diagnosis and the pathogens were killed or inhibited. The prevalence of this study was higher than other studies, 22% in Ibadan, Nigeria [34] and 22.7%, 28.5% in Ethiopia [35,36]. Study design, target population, sample size, and geographic variation may cause these differences.…”

Antimicrobial resistance pattern in healthcare-associated infections: investigation of in-hospital risk factors

“…In Iran, Behzadi et al reported that E. coli was one the most common uropathogenic bacteria causing UTI ( 16 ). In Northwest Ethiopia, among Gram-negative isolates, E. coli (63.6%) was predominant ( 17 ). Most common type of infection caused by Candida spp.…”