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Antibiotic Drug Resistance Pattern of Uropathogens in Pediatric Patients in Pakistani Population
Zakia Iqbal1,2, Ahsan Sattar Sheikh1, Anwaar Basheer3
1Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore 54000, Pakistan.
Insights
Urinary tract infections (UTIs) are common in young children. This study identified common uropathogens, *Escherichia* and *Klebsiella*, and found colistin sulphate and polymyxin B to be the most effective antibiotics against them.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Urinary tract infections (UTIs) are prevalent in children aged 0-6, potentially leading to severe urological and nephrological complications.
- Increasing antimicrobial resistance in uropathogens complicates treatment options.
- Pediatric UTIs require ongoing surveillance and effective therapeutic strategies.
Purpose of the Study:
- To identify common uropathogens causing UTIs in children in Lahore.
- To determine the antibiotic resistance patterns of these uropathogens.
- To evaluate the efficacy of various antibiotics for treating pediatric UTIs.
Main Methods:
- Analysis of 39,750 inpatient and outpatient samples from two hospitals in Lahore.
- Isolation and identification of uropathogens (*Escherichia* and *Klebsiella*) using biochemical tests, CLED agar, and microscopy.
- 16S rRNA sequencing for pathogen verification and antibiotic susceptibility testing against 23 antibiotics.
Main Results:
- *Escherichia* and *Klebsiella* were identified in 234 samples, with a higher prevalence in females (1:1.29 ratio).
- Antibiotic resistance varied between hospitals; colistin sulphate and polymyxin B showed high sensitivity (>98.8%).
- Amoxicillin, ampicillin, and cefuroxime exhibited high resistance (>90%), indicating limited efficacy.
Conclusions:
- *Escherichia* and *Klebsiella* are significant uropathogens in pediatric UTIs in Lahore.
- Colistin sulphate and polymyxin B are effective treatment options, while amoxicillin, ampicillin, and cefuroxime are largely ineffective.
- Effective antibiotic stewardship and surveillance are crucial for managing pediatric UTIs.
Abstract:
The common prevalent diseases in the age of 0 to 6 are related to urinary tract infections. If not properly diagnosed, they will lead to urological and nephrological complications. Uropathogens are developing resistance against most drugs and are harder to treat. A study was done on the inpatients and outpatients of the two hospitals located in Lahore. A total of 39,750 samples that were both male and female were collected. Escherichia and Klebsiella were found in 234 samples based on biochemical characterization, growth on CLED agar, and white blood cell/pus cell (WBC) microscopy. In comparison to males, female samples had a higher number of uropathogens (1:1.29). From the samples of Shaikh Zayed Hospital (SZH), the ratio of Klebsiella to Escherichia (1:1.93) was reported, while this ratio was 1.84:1 from the Children Hospital (CH). The incidence of UTI was higher in the month of September. Randomly selected Escherichia and Klebsiella were verified via a 16S rRNA sequence. Antibiotic resistance profiling of isolated bacterial strains was done against 23 antibiotics. The most efficient antibiotics against Klebsiella and Escherichia were colistin sulphate (100% sensitivity against bacteria from CH; 99.3% against strains from SZH) and polymyxin B (100% sensitivity against strains from SZH; 98.8% against strains from CH). Sensitivity of the total tested strains against meropenem (74%, SZH; 70% CH), Fosfomycin (68%, SZH; 73% CH strains), amikacin (74% SZH; 55% CH), and nitrofurantoin (71% SZH;67% CH) was found, Amoxicillin, ampicillin, and cefuroxime showed 100 to ≥90% resistance and are the least effective.
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