Prevalence and Antimicrobial Susceptibility of Bacterial Uropathogens Isolated from Pediatric Patients at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia

Abstract

Background Urinary tract infection (UTI) is considered as the most common bacterial infection seen among the pediatric patients. Objective This study was carried out in order to determine the prevalence of urinary tract infection in pediatric patients, identify bacterial uropathogens responsible for the infection, and study the antibiotic sensitivity patterns of bacterial isolates. Materials and Methods A cross-sectional study designed and conducted from January to April 2014. Clean-voided midstream urine specimens were obtained from 384 pediatric patients less than or equal to 15 years in sterile universal bottles. Urine collected from each patient was inoculated onto CLED and blood agar plates using a calibrated inoculating loop with a capacity of 0.001 ml. Inoculated plates were incubated for 24–48 hours at 37°C at inverted position aerobically. Bacterial isolates were indentified and characterized by Gram stain and by using an array of standard routine biochemical tests. The antimicrobial susceptibility test was carried out by using the Kirby–Bauer disc diffusion method. Frequency distribution tables were used to describe the findings. Logistical regression was also used to estimate crude odds ratio (COR) with 95% confidence interval (CI) of positive responses to the different variables, and P values less than 0.05 were taken as statistically significant. Result In this study, a total of 384 patients (199 males and 185 females) aged less than or equal to 15 years from whom urine samples were collected were enrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36 (19.5%) came up with positive cultures, while 25 (12.6%) of the 199 males had significant bacteriuria, and the largest number of study subjects were below the age of 3 years, and the largest positive culture was obtained from this age group, accounting for 35 (57.4%.) out of 61 positive cultures. Bacterial species belonging to six genera were isolated and identified from 61 positive cultures, and the genera were Escherichia, Klebsiella, Staphylococcus, Proteus, Acinetobacter, and Enterococcus. E. coli was isolated in 28 cases (49.5 %), followed by Klebsiella spp. in 17 cases (27.9%), Staphylococcus spp. in 5 patients (8.2%.) (S. aureus in one and coagulase-negative staphylococci in 4 cases), Enterococcus in 7 cases (11.5%), Proteus spp. in 3 cases (4.9%), and Acinetobacter in one case (1.6%). Of the bacterial isolates, E. coli was found out to be the most common pathogen followed by Klebsiella spp. Furthermore, E. coli and Klebsiella spp. were the most common pathogens in female patients accounting for 71.4% and 64.7%, respectively. Regarding susceptibility tests, E. coli and Klebsiella spp. were not 100% susceptible to any of the 11 antibiotics tested. Acinetobacter spp. had 100% resistance to three antibiotics: gentamicin (GN), trimethoprim-sulfamethoxazole (SXM), and augmentin (AMP). But they were 100% susceptible to ciprofloxacin (CIP), cefuroxime (CXM), norfloxacin (NOR), and ceftazidime (CAZ). On the contrary, ...

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

“…The prevalence of UTI in the present study was 16.7% (95% CI 12.7-20.4). It is in line with the study done in Addis Ababa 15.8% [18]. However, it is lower than the ndings of the studies in Gondar, 26.45% [19] and Hawassa, 27.5% [8].…”

“…As table 2 shows: cipro oxacin, cefoxitin, and ceftazidime were showed the best performance for E. coli. This is almost similar results to the ndings from Gondar Hospital and Addis Ababa, Yekatit 12 hospital [18]. According to the ndings in Gondar Hospital, the sensitivity of gentamicin and cotrimoxazole to E. coli was 80%, 73% [19] respectively.…”

“…Furthermore, the overall MDR prevalence was 66% (95% CI 52-78) which comprises Gram-negative (70.5%) and Gram-positive bacteria (33.33%). This is comparable to the ndings in the Gondar hospital pediatric patients 58.53% [30], the Addis Ababa, Yekatit 12 hospital 73.7% [18]. Although antimicrobial resistance comes primarily as a result of selective pressure to place on susceptible microbes by the use of therapeutic agents, there are also further multiplying factors for the spread of resistance.…”

“…All Gram-positive isolates showed 100% sensitive to nitrofurantoin. Similar results were obtained in Gondar hospital (77%) [30] and Addis Ababa,Yekatit 12 hospital (100%) [18]. The reason for the effectiveness of this drug might be, due to the nature of having multiple mechanisms and site of actions of the drug with a non-speci c attack of protein synthesis, would reduce the ability of bacteria to produce resistance.…”

“…In Ethiopia, different studies were done in different study groups. a study done at Hawassa referral hospital in pediatric patients showed that the prevalence of UTI was 27.5% [8], and a prevalence of 15.9% and 26.45% was reported in Yekatit 12 hospital Addis Ababa [18] and Gondar University hospital [19]. But, in the study area, there is no study done on prevalence of UTI and associated factors among children.…”