Community acquired urinary tract infection in pediatric age-group with changing trends of antibiotic resistance pattern over 3 years: a clinico-epidemiological study

Baishali Chakroborty, Sumanta Kumar Dutta, Patralekha Ray Chaudhuri, Ranjita Santra(Dhali)

Abstract


Background: Assessment of the antimicrobial sensitivity pattern in urinary isolates of the children suffering from urinary tract infection (UTI) and evaluation of the recent trends of multi-drug resistance in the isolates. The aim was to find out the antibiotics sensitivity of the organisms isolated from the urine samples of pediatric age-group with emphasis on their resistance pattern.

Methods: A clinico-epidemiological study comprising of 304 specimens of urine were collected among all the children with UTI below 12 years of age, attending pediatric outpatient department of a tertiary care teaching hospital in eastern India wet mount microscopy and semi quantitative culture were done to diagnose UTI. Organisms isolated were identified by standard biochemical tests, and antibiogram studies were done by standard Kirby-Bauer disc diffusion test statistical analysis, Microsoft excel and SPSS were used for analysis of data.

Results: Aminoglycosides had wider sensitivity pattern toward most of the uropathogens whereas tetracyclines and co-amoxyclav in particular were resistant for most of the organisms. Among all the organisms, Pseudomonas and Enterococcus species showed higher resistance pattern toward the conventional antimicrobials.

Conclusions: The changing trends in the anti-biograms of several Gram-positive and Gram-negative microorganisms in UTI demands reconsideration with respect to rational drug use in the pediatric age group.


Keywords


Urinary tract infection, Pediatric population, Antibiotic resistance, Empirical treatment

Full Text:

PDF

References


Smellie JM, Normand IC. Urinary Tract Infection: Clinical aspects in Pediatric Urology; 2nd Edition. London: Butterworth & Co; 1982: 95.

Twaij M. Urinary tract infection in children: a review of its pathogenesis and risk factors. J R Soc Promot Health. 2000;120(4):220-6.

Forbes BA, Sahm DF, Weissfeld AS. Infections of the urinary tract. In: Bailey & Scott’s Diagnostic Microbiology. 12th Edition. St. Louis: Mosby Elsevier; 2007: 842-53.

Elder JS. Urologic disorders in infants & children. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson Textbook of Pediatrics 17th Edition. Philadelphia: Elsevier; 2005: 1785-8.

Sobel JD, Kaye D. UTI. In: Mandell GL, Bennett JE, Dolin R,, editors. Mandell, Douglas & Bennett’s Principles & Practice of Infectious Diseases. 6th Edition. Philadelphia: Elsevier; 2005: 889-91.

William AP. Penicillins, cephalosporins & other β-lactam antibiotics. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman & Gillman’s the Pharmacological Basis of Therapeutics. 11th Edition. New York: McGraw Hill; 2006: 1150.

Menon EB, Tan ES. Pyuria: index of infection in patients with spinal cord injuries. Br J Urol. 1992;69(2):144-6.

Washington C, Winn Jr, Allen SD, Janda WM, Koneman EW, Schreckenberger PC, Procop GW. Koneman’s Color Atlas & Textbook of Diagnostic Microbiology. 6th Edition. Baltimore, USA: Lippincott Williams & Wilkins; 2006: 1443-75.

National Collaborating Centre for Women’s & Children’s Health. UTI in Children, Diagnosis, Treatment & Long-Term Management. London, UK: National Institute for Health & Clinical Excellence (NICE); 2007: 148.

Nesher L, Novack V, Riesenberg K, Schlaeffer F. Regional community-acquired urinary tract infections in Israel: diagnosis, pathogens, and antibiotic guidelines adherence: a prospective study. Int J Infect Dis. 2007;11(3):245-50.

Brown R, Poxton IR. Centrifuges, colorimeters and bacterial counts. In: Collee JG, Fraser AG, Marmion BP, Simmons A, editors. Mackie & McCartney Practical Medical Microbiology. 14th Edition. New York: Churchill Livingstone; 2007: 850.

Jorgensen JH, Ferraro MJ. Antimicrobial susceptibility testing: A review of general principles and contemporary practices. Clin Infect Dis. 2009;49(11):1749-55.

Brumfitt W. Detection & Assessment of Urinary Infection: Recent Advances in Clinical Pathology. London: J & A Churchill Ltd.; 1968: 19-30.

Leigh D. Urinary tract infection. In: Parker MT, Collier LH,, editors. Topley & Wilsons Principles of Bacteriology, Virology & Immunity. 8th Edition, Volume 3. London: Edward Arnold; 1990: 198.

Pape L, Gunzer F, Ziesing S, Pape A, Offner G, Ehrich JH. Bacterial pathogens, resistance patterns and treatment options in community acquired pediatric urinary tract infection. Klin Padiatr. 2004;216(2):83-6.

Goldstein FW. Antibiotic susceptibility of bacterial strains isolated from patients with community-acquired urinary tract infections in France. Multicentre Study Group. Eur J Clin Microbiol Infect Dis. 2000;19(2):112-7.

Laupland KB, Ross T, Pitout JD, Church DL, Gregson DB. Community-onset urinary tract infections: a population-based assessment. Infection. 2007;35(3):150-3.