Clinical Profile and Antibiotics Sensitivity in Childhood Urinary Tract Infection at Dhulikhel Hospital

Abstract

BackgroundUrinary Tract Infection implies presence of actively multiplying organisms in the urinary tract. Although it is infrequently associated with mortality, it is still a significant cause of morbidity. Early diagnosis is critical to preserve renal function of growing kidney. ObjectiveOur purpose was to determine the clinical, microbiologic profile and antibiotic sensitivity of such infections in pediatric Urinary Tract Infection (UTI) patients at Dhulikhel Hospital. MethodsA hospital based prospective descriptive study of 135 children from 2 months to 16 years, with clinical diagnosis of urinary tract infection who visited the pediatric department of Dhulikhel Hospital over the period of 15 months were enrolled in the study. All patients underwent routine urine analysis and culture. Children with recurrent UTI underwent micturating cystourethrogram (MCUG). Children with recurrent UTI of more than two years and with feature of pyelonephritis underwent USG abdomen as well. Complications and response of the treatment was observed in all cases of UTI. All data were entered in Epidata and data analysis was done using spss 16 version. ResultsAmong 135 children, 32.5% were male and 67.4% were female. Fever was the most common presenting symptom in 74.80% of patients followed by dysuria in 54.1%. Among these children 95.6% had significant pyuria and 45% had culture positive infection. Children who showed positive for bacteriuria, Escherichia coli (78.7%) was the most common organism and are more than 80% sensitive to Amikacin, Gentamicin, Ceftriaxone, Ofloxacin, Nalidixic acid, Imipenem and Vancomycin. Co-trimoxazole was the most common drug used for treatment with a mean drug respond time of (mean±S.D) of 2.21±.78 days. 2±±. Children who had recurrent UTI were more prone to develop culture positive UTI (p=0.0001). ConclusionUrinary Tract Infection in female was almost twice more common than in male. Cotrimoxazole was the most common drug used for treatment, sensitivity of this drug was less than 50% for all organisms.

Microbiological Profile of Urinary Tract Infection in Children With Vesicoureteric Reflux and Comparison of E Coli and Non-E Coli Infections.

“…As reported in other studies, most UTIs are caused by uropathogenic Escherichia coli, followed by Klebsiella pneumonia, Enterococcus, Proteus, Acinetobacter, etc. 10,11 In our study, the most common organisms isolated were E. coli (67%), K. pneumonia (14.3%), Enterococcus (12.9%), Acinetobacter (4.3%), and Proteus (1.4%). These findings are consistent with findings by other studies by Mcloughlin TG.…”

Bacterial Aetiology and Antibiotic Resistance Pattern of Community-Acquired Urinary Tract Infections in Children in a Tertiary Care Hospital in Bangladesh

“…However, compared to reports from Nepal, we observed a considerable increase in resistance against penicillins, aminoglycosides, quinolones and ceftriaxone. 12 Lower rates of resistance among the paediatric isolates causing UTI have been documented in western countries. 31 In the present study Klebsiella isolates showed resistance against broad spectrum cephalosporin, macrolides and amoxicillin/clavulanic acid which is consistent with the previous data of other communitybased studies.…”

“…9 Most of the studies on paediatric urinary tract infections caused by multidrug resistant bacteria have been done in western world 10,11 , but these types of studies are scarce in South Asian region. 12 However, there are not much information on aetiology and resistance pattern of community acquired UTIs in Bangladesh. But drug resistance is spreading fast mainly due to overuse or underuse of antibiotics, incomplete medications and widespread practice of feeding livestock with low levels of antibiotics to promote growth.…”

To study common cause of UTI in Female patients coming to Hospital with Special focus to restrain Antibiotic resistance

“…Infection (UTI) implies the presence of actively multiplying organisms in the urinary tract (4,5) and it occurs in 3-5% of girls and 1% of boys during childhood, while it is more common in boys during the first year of life (6) . Every year about 250 million people worldwide are affected by UTIs.…”