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Bacterial isolates and their antimicrobial susceptibility patterns among pediatric patients with urinary tract
Birhanu Ayelign1, Betelehem Abebe2, Adugna Shibeshi2
1Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Insights
Pediatric urinary tract infections (UTIs) in Ethiopia show high rates of uropathogenic bacteria and significant antimicrobial resistance, especially to ampicillin. This highlights the need for localized antibiotic sensitivity data to guide effective treatment strategies.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Antimicrobial resistance
Background:
- Urinary tract infections (UTIs) are common in children and can lead to severe health issues.
- Limited data exists on uropathogen prevalence and antibiotic resistance patterns in pediatric UTIs in resource-limited settings like Ethiopia.
Purpose of the Study:
- To identify common bacterial isolates causing UTIs in pediatric patients.
- To determine the antimicrobial susceptibility patterns of these isolates.
- To inform appropriate diagnosis and treatment strategies for pediatric UTIs in Ethiopia.
Main Methods:
- A cross-sectional study involving 310 pediatric patients.
- Bacterial identification using standard culture and biochemical tests.
- Antimicrobial susceptibility testing via the disc diffusion method.
- Statistical analysis using chi-square test (p<0.05).
Main Results:
- 82 (26.45%) bacterial isolates were detected, with Gram-negative bacteria predominating.
- Escherichia coli was the most common pathogen (54.88%), followed by Staphylococcus aureus and Pseudomonas aeruginosa.
- High resistance rates were observed for ampicillin (up to 100% for some strains) and tetracycline (37.80%).
- Malnutrition, catheterization history, and prior UTI were independently associated with UTI.
Conclusions:
- A significant prevalence of uropathogenic bacteria and substantial drug resistance, particularly to ampicillin, was found.
- Antibiotic selection for pediatric UTIs should be guided by local bacterial prevalence and sensitivity data, not empirical treatment.
- Findings underscore the need for updated antimicrobial stewardship in pediatric care within Ethiopia.
Objective:
Urinary tract infection is a common pediatric problem with the potential to produce long-term morbidity. Therefore, appropriate diagnosis and prompt treatment is required. However, studies about magnitude of uropathogenicity and antimicrobial resistance pattern of pediatric urinary tract infection (UTI) are lacking in resource limited countries including Ethiopia. This study was aimed to determine bacterial isolates, antimicrobial susceptibility pattern among pediatric patients with UTI.
Material And Methods:
A cross- sectional study was conducted. Pathogenic bacterial isolates were identified by culture and biochemical methods following standard procedures. Antimicrobial susceptibility testing of the isolates for commonly used antibiotics was done using the standard disc diffusion method on Muller Hinton agar. Associations between dependent and independent variables were measured using chi-square test and within 95% confidence interval. P values <0.05 were considered as statistically significant.
Results:
A total of 310 pediatric patients were included in the study, and 82 (26.45%) bacterial isolates were detected. Gram- negative bacteria were predominant etiologic agents of UTI in this study. E. coli was the most frequently occurring pathogen (n=45; 54.88%) followed by S. aureus and P.aeruginosa (n=8; 9.75% for both), P. vulgaris, P.aeruginosa (n=4; 4.88%, for both) and Enterococcus species (n=3; 3.66%). All K. pneumoniae, P. mirabilis, and K. ozanae straines were 100% resistance to ampicillin, followed by P. aeruginosa (87.5%) and E. coli (69%). While all Gram- positive bacterial isolates were 100% sensitive to ciprofloxacin. Malnutrition, history of catherization and previous history of UTI were independently associated with UTI (p=0.000).
Conclusion:
There was a high prevalence of uropathogenic bacteria and drug resistance particularly to ampicillin (72%) and tetracycline (37.80%). This condition indicates that antibiotic selection should be based on knowledge of the local prevalence of bacterial organisms and antibiotic sensitivities rather than empirical treatment.
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