Prevalence of urinary tract infection and sensitivity pattern amongst children less than 3 years of age with fever in a tertiary care hospital in South Karnataka

Abstract

Background: Antimicrobial resistance is a major concern especially in urinary tract infections in children as improperly treated urinary tract infections (UTIs) on long term can cause renal scarring in young children, which leads to long term morbidities like hypertension, chronic renal disease and pre-eclampsia. The empirical therapy for UTI varies regionally due to their varied sensitivities and resistance pattern. This study aims to facilitate policy making in empirical antibiotic therapy of pediatric patients with urinary tract infections.Methods: A cross sectional study, which included a group of 140 children’s (6 months to 3 years) with fever were included in the study. All patients with colony count >1 lakh CFU/ml or colony count >50,000 CFU/ml, with leukocyturia (>5 WBCs/HPF in centrifuged urine) or colony count >1000 CFU/ml with urinary symptoms were diagnosed to be positive for urinary tract infection.Results: The prevalence of UTI in febrile children less than 3 years in our study was 0.1%. Out of 140 patients with fever, 35 were UTI positive. E. coli was the most commonly isolated organism (60%), followed by MRSA (14.2%) and Enterococci (11.4 %). E. coli was found to be most sensitive to nitrofurantoin (85.7%), followed by gentamicin (61.9%) and norfloxacin (38%). E. coli showed high resistance to cefuroxime (76.2%) and ceftriaxone (71.4%). MRSA was found to be most sensitive to linezolid and vancomycin, and resistant to norfloxacin.Conclusions: The data shows the increased resistance of E. coli to commonly prescribed antibiotics like cefuroxime and ceftriaxone. So, this study shows the empirical treatment of UTI in our region and the importance of having antibiotic prescription policies in every region.

Urinary tract abnormalities in children with first urinary tract infection

“…In contrast, Ahmadzadeh et al [10] reported a higher incidence of abnormalities (60.6%), as majority (77%) of their study group were children aged less than 5 years. The most common abnormality detected in our study was VUR, which was similar to other studies [9][10][11][12]16], of which 37.5% (3/8) had bilateral VUR. similar results obtained by other studies are compiled in Table 3.…”

“…In our study, fever was the most common presenting symptom (86%) which was similar to the studies done by Ahmadzadeh et al [10] (83%) and Ponvelil et al (74.2%) [11]. Urinary symptoms were seen in only 14%.…”

“…Hence, UTI may be missed if urine culture is not done. We found that E. coli was the most common organism isolated (64%), followed by Klebsiella (16%), which was similar to the studies done by Zamir et al [12], Ahmadzadeh et al [10], Ponvelil et al [11], Saadeh et al [13], and Nair et al [11]. In contrast, a study done by Nowell et al [14] reported higher isolation rates of coagulase-negative Staphylococcus aureus (28%) over E. coli (17%).…”

Prevalence of urinary tract infection and sensitivity pattern in febrile children less than 5 years of age

“…Sensitivity of E. coli to cefotaxime in our study was similar to study by Badhan et al 22 In contrast study done by Patel et al and Ponvelil et al E. coli was found most sensitive to imipenem and nitrofurantoin. 23,24 In our study E. coli was highly resistance to cefepime, cefurorixme, cefixime, gentamycin, ampicillin and amoxicillin. In contrast other study shows high resistance to fluroquinolones.…”

Bactericidal Effect of Antibiotics against Bacteria Causing Urinary Tract Infection among Children

“…In our study, there were 11 (15.5%) males and 60 (84.5%) females. Female predominance is mostly because of its short urethra [5] [25] found only 33.3% sensitivity to Amikacin. The sensitivity pattern of drugs is changing and due to rational use of the antibiotics the uropathogens are becoming resistant to multiple drugs.…”