Microbiologic spectrum and susceptibility pattern of urinary isolates from pediatric patients in a superspecialty Hospital: A 3-year experience

Abstract

Introduction: UTI causes significant child morbidity and mortality. Enterobacteriaecae are most common uropathogens. Recently Enterococcus spp , yeast and Staphylococcus aureus have emerged as paediatric uropathogens. Understanding of local susceptibility pattern guides antibiotic therapy in UTI. This study describes demographic and susceptibility profile of uropathogens in children. Method: The urinary isolates were analysed retrospectively and data on age, sex, result of urine culture, etiological agent and susceptibility pattern were obtained from laboratory record books. Result: 315 urine samples analysed showed 34% significant bacteruria. Prevalence of UTI among male and female children was 62% and 37.9% respectively, statistically significant ( P = .0329). Predominant uropathogens were Klebsiella spp. (66.6%), Escherichia coli (25.9%), Candida albicans (20.3%) and Enterococcus spp (15.7%). Bacteruria with pyuria was 26.03%. Sterile pyuria present in 9.52% of cases. A statistically significant correlation between Pseudomonas and pyuria was noted. Both Klebsiella spp and E coli were least susceptible to augmentin and cephalosporins (25%) and most susceptible to carbapenems. Proteus spp was most susceptible to aminoglycosides (75%) and Acinetobacter spp to Piperacillin-tazobactam (83.3%) while Pseudomonas to carbapenem (75%). Acinetobacter was most resistant with 100% resistance to augmentin, cephalosporins, aminoglycosides, fluoroquinolones and nitrofurantoin. All GNRs were 100% resistant to nitrofurantoin except E coli (39.2%) and Klebsiella spp (41.6% ) susceptible. Enterococcus were 100% sensitive while 87.5% of Staphylococcus aureus were sensitive to teicoplanin and linezolid. Conclusion: Ongoing monitoring should note any changes in paediatric uropathogens and their antibiotic resistance pattern to guide the clinicians for proper empirical management of UTI in children.