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 appropriate management of cases. The aim of this study was 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 hours.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 the rate of 44/50 (88%) and 6 (12%) respectively. Among Gram-negative isolates, E.coli (56%) was the predominant while S. saprophyticus(6%) wasprevalent among Gram-positive bacterial isolates.Overall, a high level of resistance to ampicillin, Augmentin, and tetracycline was observed with the rate of 100%, 68.16%, 65.91% respectively. About 66% of multidrug resistance was observed (95% CI 52-78). 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 The prevalence of urinary tract infection among children was high and considerably a high proportion of multidrug resistance was observed in the present study. This result will have a significant impact on selection of appropriate antimicrobial agents for the treatment of urinary tract infection.

Magnitude and associated factors of bacterial urinary tract infections among paediatric patients in Arba Minch, southern Ethiopia

“…We have found that Gram-negative bacterial isolates exhibited high rates of resistance towards amoxicillin-clavulanate (89.5%), ampicillin (84.6%), tetracycline (73.7%) and co-trimoxazole (68.4%). This is in agreement with the findings of previous studies conducted in Bahir Dar, Ethiopia [ 22 , 31 ], Kenya [ 36 ] and Nigeria [ 37 ]. Our results imply that these antibiotics have only the least efficacy and hence cannot be used in an empirical therapy for the management of UTI in children in the study area.…”

“…Results of our study also revealed that isolates of E. coli were highly resistant to ampicillin, amoxicillin-clavulanate and tetracycline 77.8% each (7/9), and co-trimoxazole 66.7% (6/9), which are comparable to the outcome of studies conducted in Bahir Dar, Ethiopia [ 22 ], and Nepal [ 33 ]. In addition, it is to be noted that 77.8% (7/9), 66.7% (6/9) and 55.% (5/9) of E. coli were resistant to ceftazidime, cefuroxime and ceftriaxone, respectively, which are comparable to the results of studies conducted in India [ 38 ] and Bangladesh [ 39 ].…”

“…The sample size was calculated using a single population proportion formula (N= (Zα/2) 2 P (1-P)/D 2 ) [ 23 ]. To determine the required sample size, a prevalence of 16.7% was taken from a previous study conducted in the northwestern part of Ethiopia [ 22 ]. After considering a confidence interval of 95% (z = 1.96) and 5% of marginal error (d = 0.05), the initial sample size was computed as 214, and by including a 15% non-response rate, the final sample size was consolidated as 246 (n).…”

“…Moreover, in developing countries, more than 80% of bacterial strains causing UTI in children are now resistant to co-trimoxazole, an antibiotic commonly prescribed for the treatment of uncomplicated UTI [ 20 ]. Findings from previous studies on childhood UTI in other parts of Ethiopia indicated that multi-drug resistant (MDR) bacterial uropathogens are rising, and geographical variations of common bacterial etiologies of UTI exist in the country [ 21 , 22 ].…”

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

“…In Ethiopia, few studies were conducted to determine urinary tract infections among pediatric patients: the study at Hawassa referral hospital, Yekatit 12 hospital, Felege-Hiwot specialized, and Gondar University hospitals revealed 27.5%, 19 15.9%, 20 16.7%, 21 and 26.45%, 22 respectively. The lack of urine culture in health facilities with different levels in developing countries including Ethiopia remained impractical as they are resource-intensive.…”