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Evaluation of bacteriological profile and antibiotic sensitivity patterns in children with urinary tract infection: A
Ranjana Badhan1, Dig Vijay Singh2, Lashkari R Badhan1
1Department of Pediatrics, R.V. Multispecialty Hospital, SBS Nagar, Punjab, India.
Insights
This study identified common bacteria causing urinary tract infections (UTIs) in children and their antibiotic sensitivities. Nitrofurantoin, amikacin, and cefotaxime were effective against common Gram-negative bacteria in pediatric UTIs.
Area of Science:
- Pediatric infectious diseases
- Clinical microbiology
- Antimicrobial resistance surveillance
Background:
- Regional surveillance is crucial for developing community-acquired urinary tract infection (UTI) guidelines, especially in underserved areas.
- Empirical treatment is common in rural settings due to limited diagnostics.
- This study aimed to assess the bacteriological profile and antibiotic sensitivity in children with UTI.
Purpose of the Study:
- To prospectively evaluate the bacteriological profile of UTIs in children.
- To determine antibiotic sensitivity patterns for common uropathogens in pediatric patients.
- To inform regional UTI treatment guidelines for children.
Main Methods:
- Prospective study of 800 children (0-18 years) with suspected UTI.
- Urine microscopy, Gram staining, and culture performed for all suspected cases.
- Disk diffusion method used for antibiotic sensitivity testing following CLSI guidelines.
Main Results:
- Escherichia coli was the most common pathogen (42.3%), followed by Enterococcus fecalis (13.5%).
- Gram-negative isolates showed sensitivity to nitrofurantoin, cefotaxime, and amikacin.
- Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin.
Conclusions:
- E. coli is the predominant cause of pediatric UTI, with E. fecalis, Klebsiella spp., and S. aureus also significant.
- Nitrofurantoin, amikacin, and cefotaxime are effective against Gram-negative UTIs in children.
- Periodic regional studies are essential for updating UTI bacteriology and sensitivity patterns in pediatric populations.
Introduction:
Development of regional surveillance programs is necessary for the development of community-acquired urinary tract infection (UTI) guidelines, especially for sub-urban and rural areas where empirical treatment is the mainstay in the absence of proper diagnostic modalities. Our aim was to evaluate the bacteriological profile and antibiotic sensitivity patterns in children with UTI prospectively from a tertiary care center.
Methods:
A total of 800 children up to 18 years of age with suspected UTI attending our center were included. For all suspected cases urine microscopy, gram staining, and culture were done. Antibiotic sensitivity was performed on selected antimicrobials using disk diffusion method following Clinical Laboratory Standards Institute guidelines.
Results:
Majority of pathogens were isolated from female (54.2%) patients. Pre-teens (52.1%) and teens (27.1%) were most commonly affected age group. The most common presentation in culture-proven UTI was fever with urinary symptoms (33.3%). In a group of 192 patients 26.7% had proven UTI. Escherichia coli (42.3%) was the most common aetiological agent, followed by Enterococcus fecalis (13.5%), Klebsiella spp. (11.5%) and Staphylococcus aureus (11.5%). Most active antibiotics against Gram-negative isolates were nitrofurantoin, cefotaxime, and amikacin. Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin.
Conclusion:
E. coli was the commonest isolate. The organisms grown in significant numbers were E. fecalis, Klebsiella spp. and S. aureus, causing UTI in 0-18 years of age group. Gram-negative isolates were sensitive to nitrofurantoin, amikacin, and cefotaxime. Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin. Prospective, regional studies are ensured periodically to explain bacteriological profile and antibiotic sensitivity patterns to be applicable for children with UTI over that geographic area.
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