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.