A clinical study of uropathogens causing urinary tract infection in children and adolescents in a tertiary care hospital

Authors

  • R. Abisha Rezia Department of Pharmacology, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India
  • R. Vijendra Department of Pharmacology, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India
  • Anjana Gopi Department of Microbiology, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20204094

Keywords:

Urinary tract infection, Children, Adolescents, Antimicrobial drug resistance

Abstract

Background: Urinary Tract Infection (UTI) is one of the common infections in children. Incidence varies with age, race and gender. UTIs have become difficult to treat due to development of resistance among uropathogens. Regional data regarding the common uropathogens and their antimicrobial susceptibility pattern is required to guide the clinicians to start empirical therapy while treating UTIs.

Aims: This study is aimed to study the profile of uropathogens causing UTI in children and adolescents, assess their antimicrobial susceptibility, the clinical course and outcome.

Methods: All subjects with suspected UTI whose urine samples grew a positive culture of uropathogens were included in this prospective observational study. The study was done in the Department of Microbiology from July 2019 to December 2019. The urine samples were processed by standard methods (using 5% sheep blood agar and MacConkey agar) and antimicrobial susceptibility was performed using the Kirby-Bauer disk diffusion method. The details of the pathogens grown, and their antimicrobial sensitivity and resistance patterns were recorded, and the subjects were followed up during their course in the hospital.

Results: A total of 109 urine samples from paediatric and adolescent subjects showed positive cultures (97.32%). UTI was common among toddlers (46.7%). E. coli contributed to 40.3% of the cases, followed by Enterococcus and Klebsiella pneumonaie. E. coli was resistant to amoxicillin + clavulanic acid, cephalosporins and ciprofloxacin. The organisms were sensitive to meropenem, amikacin and piperacillin + tazobactam.

Conclusion: Incidence of UTI and the uropathogens causing UTI varies with age. Different uropathogens and their resistance to commonly used antimicrobials is a concern for future treatment options in UTI.

References

Gulati S, Kher V. Urinary tract infection. Indian Pediatr. 1996;33:212-7.

Bickerton MW, Ducket JW. Urinary tract infection in pediatric patients. American Urological Association, Houston, Texas. 1985.

Shaw KN, Gorelick M, Mcgowan KL, Yakscore NM, Schwartz JS. Prevalence of urinary tract infection in febrile young children in the emergency department. Pediatr. 1998;102:16-21.

Elder JS. Urinary tract infections. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BE, editors. Nelson Textbook of Pediatrics. Philadelphia: Saunders. 2007;2223-8.

Watson AR. Disorders of the urinary syastem. In: Campbell AG, McIntosh N, editors. Forfar and Arneil’s Textbook of Pediatrics. Churchill Livinstone. 1998;949-56.

Bachur R, Harper MB. Reliability of the urinanalysis for predicting urinary tract infections in young febrile children. Arch Pediatr Adoles Med. 2001;155:60-5.

Chon CH, Lai FC, Shorthffe LM. Pediatric urinary tract infections. Pediatr Clin North Amer. 2001;48:1447-59.

Oak SN, Agarwal P. Urinary tract infection in children and role of surgery. Asian J Pediatr Practice. 2001;4:43-6.

Srivaths PR, Rath B, Krishna PS, Talukdar B. Usefulness of screening febrile infants for urinary tract infection. Indian Pediatr. 1996;33:218-20.

Chantler C, Berman LH, Jones FC, Gruneberg RN, Haycock GB. Guidelines for the management of acute urinary tract infection in childhood. J Roy Col Physician London. 1991;25:36-41.

Jones RN, Thornsberry C. Cefotaxime: a review of in vitro antimicrobial properties and spectrum of activity. Rev Infect Dis. 1982;4:5300-15.

Manges AR, Johnson JR, Foxman B, O’Bryan TT, Fullerton KE, Riley LW. Widespread distribution of urinary tract infections caused by a multidrug-resistant Escherichia coli clonal group. New Engl J Med. 2001;345:1007-13.

“WHO publishes list of bacteria for which new antibiotics are urgently needed.” WHO, 27 February 2017, https://www.who.int/news-room/detail/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed. Last accessed on 29 June 2020.

Palikhe N. Prescribing pattern of antibiotics in pediatric hospital of Kathmandu Valley. Kathmandu Univ Med J. 2004;2:6-12.

Oreskovic NM, Sembrano EU. Repeat urine cultures in children who are admitted with urinary tract infections. Pediatr. 2007;119:325-9.

Moderres S, Oskoii NN. Bacterial etiologic agents of urinary tract infection in children in the Islamic Republic of Iran.Eastern Mediterranean Health J. 1997;3:290-5.

Das RN, Chandrashekhar TS, Joshi HS, Gurung M, Shrestha N, Shivananda PG. Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in Western Nepal. Singapore Med J. 2006;47:281-5.

Al-Ibrahim AA, Girdharilal RD, Jalal MA, Alghamdy AH, Ghazal YK. Urinary tract infection and vesicoureteral reflux in Saudi children. Saudi J Kidney Dis Transplant. 2002;19:24-8.

Rajbhandari R, Shrestha J. Bacteriological study of urinary tract infection and its antibiotic sensitivity test: a hospital based study. J Nepal Assoc Med Lab Sci. 2002;4:26-32.

Shrestha B, Basnet RB, Shrestha P, Shahi P. Prevalence of urinary tract infection in female patients attending Kathmandu. Model Hospital. J Nepal Assoc Med Lab Sci. 2005;7:10-4.

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Published

2020-09-22

How to Cite

Rezia, R. A., Vijendra, R., & Gopi, A. (2020). A clinical study of uropathogens causing urinary tract infection in children and adolescents in a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 9(10), 1549–1553. https://doi.org/10.18203/2319-2003.ijbcp20204094

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Original Research Articles