Clinical profile and gram negative bacterial profile of urinary tract infection in children attending a tertiary care hospital of Tamilnadu, India

Authors

  • Vasuki Balasubramanyam Department of Pediatrics, Saveetha Medical College, Saveetha University, Chennai, Tamilnadu, India
  • Natwar Lal Sharma Department of Pediatrics, Saveetha Medical College, Saveetha University, Chennai, Tamilnadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20164610

Keywords:

Antibiotic susceptibility, Bacterial isolates, Dysuria, UTI

Abstract

Background: Urinary tract infection (UTI) is one of the most common infections caused by bacterial pathogens seen mostly in developing countries. This study was done to assess the clinical and gram negative bacterial profile of pathogens causing urinary tract infection, which helps the clinician to diagnose early and give presumptive antibiotic to prevent complications.

Methods: Specimen was collected in sterile, leak proof container by clean catch mid-stream technique. Isolation of uropathogens was performed by a surface streak procedure on both blood agar and Mac Conkey Agar (Himedia, India) using semi quantitative method by using standard loop technique and Identified as per standard CLSI guidelines. Antibiogram of the isolates was performed and read as per standard manufacturer’s instructions.

Results: UTI was more common in female children than male, and half were in the age group 1-5 years. Fever is the most common presentation (58.6%) followed by dysuria (46.4%) abdominal pain (45%) and decreased appetite (23.6%). Escherichia coli was the most common (73.6%) isolate followed in order by Klebsiella sps (15.7%), Citrobacter sps (2.1%) Proteus sps (5%) and Pseudomonas sps (3.5%). Nitrofurantoin (86%) was the most sensitive antibiotic followed by cefexime (84.7%), gentamicin (82%) and ciprofloxacin (81%) for E. coli. Klebsiella was sensitive to gentamycin, ciprofloxacin. Greater degree of resistance was noted to ampicillin, cotrimoxazole and nalidixic acid.

Conclusions: The common clinical feature assosciated with UTI was fever and commonest causative organism for UTI was E. coli. The appropriate antibiotic in-vitro were cefexime and gentamicin in this study. Higher degree of resistance was found in antibiotics such as amipicllin, cotrimioxazole, cephalexin, nalidixicacid. 

References

Mittal R, Aggarwal S, Sharma S, Chhibber S, Harjai K. Urinary tract infections caused by pseudomonas aeruginosa: a mini review. J Infect Public Health. 2009;2:101-11.

Beyene G, Tsegaye W. Bacterial uropathogens inurinary tract infection and antibiotic susceptibility pattern in Jimma University specialized hospital, southwest Ethiopia. Ethiop J Health Sci. 2011;21(2):141-6.

Ponugoti M, Venkatakrishna M. Study of virulence factors of uropathogenic Escherichia coli and its antibiotic susceptibility pattern in a tertiary care hospital. J Biosci Tech. 2015;6(1):602-6.

Watson AR, Taylor CM, McGraw M. Disorders of the urinary system. Forfar and Arneil’s Textbook of Pediatrics, 6th eds.Neil McIntosh, Peter Helms, Rosalind Smyth. Churchill. Livingstone, Spain. 2003:613-20.

Schlager TA. Urinary tract infections in children younger than 5 years of age: epidemiology, diagnosis, treatment, outcome and prevention. Paediatr Drugs. 2001;3:219-27.

Forbes BA. Bailey and Scott’s diagnostic microbiology, 10th ed. St. Louis, Missouri: Mosby; 1998L283–304.

Performance standards for antimicrobial susceptibility testing; 16th informational supplement. M100-S16. Clinical and Laboratory Standards Institute. Wayne PA; 2006.

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(4):281.

Shukla OP, Singh N. Urinary tract infection 1-12 years age group: a cross section study of 100 cases. IAIM. 2015;2(6):192-6.

Dielubanza EJ, Schaeffer AJ. Urinary tract infections in women. The Medical clinics of North America. 2011;95(1):27-41.

Kolawale AS, Kolawale OM, Kandaki-Olukemi YT, Babatunde SK, Durowade KA, Kplawale CF. Prevalence of urinary tract infections among patients attending Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria. Int J Med Med Sci. 2009;1(5):163-7.

Gupta KD, Scholes WE, Stamm. Increasing prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in women. J Am Med Assoc. 1999;281:736-8.

Moges AF, Genetu A, Mengistu G. Antibiotic sensitivities of common bacterial pathogens in urinary tract infections at Gondar Hospital, Ethiopia. East Afr Med J. 2002;79:140-2.

Sibi G, Devi AP, Fouzia K, Patil BR. Prevalence, microbiologic profile of urinary tract infection and its treatment with trimethoprim in diabetic patients. Res J Microbiol. 2011;6:543-51.

Khameneh ZR, Afshar AT. Antimicrobial susceptibility pattern of urinary tract pathogens. Saudi J Kidney Dis Transpl. 2009;20:251-3.

Shalini, Joshi MC, Rashid MK, Joshi HS. Study of antibiotic sensitivity pattern in urinary tract infection at a tertiary hospital. NJIRM. 2011;2(3):43-4.

Nakhjavani FA, Mirsalehian A, Hamidian M, Kazemi B, Mirafshar M, et al. Antimicrobial susceptibility testing for Escherichia coli strains to fluoroquinolones, in urinary tract infections, Iranian. J Publ Health. 2007;36(1):89-92.

Basnet BB, Acharya K, Khana S, Dahal RK. Trends in antimicrobial resistance among common isolates of urinary tract infection in tertiary care hospital of Nepal. Int Res J Pharm App Sci. 2013;3(4):22-6.

Bashir MF, Qazi JI, Ahmad N, Riaz S. Diversity of urinary tract pathogens and drug resistant isolates of Escherichia coli in different age and gender groups of Pakistanis. Trop J Pharma Res. 2008;7(3):1025-31.

Sharma A, Shrestha S, Upadhya S, Rijal P. Clinical and bacteriological profile of urinary tract infection in children at Nepal Medical College Teaching Hospital, Nepal. Med Col J. 2011;13(1):24-6.

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Published

2016-12-21

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Original Research Articles