Prevalence and antimicrobial sensitivity pattern of urinary tract infection among children with cerebral palsy, Moshi, Tanzania

Abstract

BackgroundUrinary tract infection (UTI) in children with cerebral palsy (CP) is a challenging yet common clinical condition. Children with CP bare the greatest risk of contracting UTI because of their difficulties in neuromotor control which lead to delay of bladder control, causing incomplete bladder emptying and urine retention.MethodThis was an analytical cross-sectional study that was conducted from September 2016 to March 2017 at Comprehensive Community Based Rehabilitation in Tanzania – Moshi and Kilimanjaro Christian Medical Centre Neurological Pediatrics Outpatient Clinic. All children who met the inclusion criteria were studied. Urine samples were collected at one point by catheterization, and urine dipstick and urine culture were done. Data were analyzed using SPSS version 20.ResultsA total of 99 children were enrolled in the study. The median age was 4 years (3–8 years); 53.5% were aged between 2 and 4 years. More than half were male. UTI was detected in 13.1% (n=13) of the children. Five causative agents of UTI were isolated, namely Escherichia coli, Proteus mirabilis, Klebsiella pneumonia, Staphylococcus aureus, and Enterococcus faecalis. The two most common organisms, E. coli and P. mirabilis, both had low sensitivity to ampicillin and co-trimoxazole while they were sensitive to ciprofloxacin and ceftriaxone.ConclusionUTI is a common finding among children with CP. E. coli and P. mirabilis are the commonest causative agents and are sensitive to ciprofloxacin and ceftriaxone but have low sensitivity to ampicillin and co-trimoxazole.

Microbiological Characterisation of Community-Acquired Urinary Tract Infections in Bagamoyo, Tanzania: A Prospective Study

“…Likewise, resistance to ampicillin and cotrimoxazole was high, but only 11% of E. coli isolates displayed resistance to ciprofloxacin, which is lower than we observed in our study. Similar findings were reported from an analysis of UTIs in Tanzanian children with cerebral palsy [12], in people living with human immunodeficiency virus (HIV) infection [13] and in pregnant women [14]. Another prospective study from a northern area of the country identified the diagnosis of UTIs as being significantly associated with E. coli bloodstream infections, which underlines the possible severe consequences of untreated or inadequately treated infections [15].…”

Prevalence and Risk Factors of Urolithiasis in Children with Cerebral Palsy

“…In the current study the percentage of Pus cells and Crystals was higher among CP children and urine culture was positive in 17.5% of cases indicating urinary tract infection in those children. This agrees also with other studies such as Ryakitimbo et al [38] The study included all children aged 2-18 years who were diagnosed to have CP (99 children with CP). UTI was detected in 13.1% of cases.…”

Comorbidities in Children with Cerebral Palsy

“…Excessive secretions due to GER or swallowing disorders, inefficient coughing will lead to an inefficient clearance of secretions and thus favour respiratory infections. 22 UTI was revealed in 9% of cases, which is not very different from the prevalence of Ryakitimbo et al 23 in Tanzania in 2018, which was 13.1%. Constipation would have an impact on the occurrence of urinary tract infection.…”

“…24 Factors that increase the risk of acquiring urinary tract infection in CP include low cognition, limited ability to communicate the need to void, impaired mobility, and bladder dysfunction. 23 Patients with GMFCS V were at greater risk of developing nutritional disorders and orofacial dyspraxia. Indeed, Bearden et al 12 found that malnutrition is more frequent in subjects with GMFCS≥IV.…”