Nosocomial significant bacteriuria: prevalence and pattern of bacterial pathogens among children hospitalised for non-infective urinary tract disorders.

Abstract

This study was undertaken to determine the prevalence of nosocomial significant bacteriuria (NSB) and pattern of bacterial pathogens among children hospitalised for non-infective urinary rtract disorders (NUTDs) namely, acute glomerulonephritis, nephrotic syndrome, renal failure and congenital urinary tract anormalies in our nephrology unit. Serial midstream or suprapubic puncture urine specimens were collected into sterile plastic universal bottles from the patients for microscopy, culture and sensitivity, using the standard laboratory methods. Seventeen of the 96 patients admitted for NUTDs were excluded from the study based on the set exclusion criteria; only 19 out of the 79 patients studied were found to have NSB giving a prevalence rate of 24.05%. The isolated pathogens included Klebsiella spp. (47.37%). Staphylococcus aureus (31.58%). Escherichia coli (10.53%), Pseudomonas spp. (5.26%) and Citobacter spp. (5.26%). While 78.95% and 69.23% of the isolates were sensitive to gentamicin and cefuroxime respectively, 57.9% were sensitive to ceftazidime and nitrofurantoin. Less than 50% of the isolates were sensitive to each of the other antibiotics tested. Five of the patients died giving a case fatality rate of 26.3%. In this study, NSB is evidently a very common health problem and a significant risk factor for mortality in patients with NUTDs. Weekly urine culture is recommended in any hospitalised child with NUTD in order to diagnose and manage NSB early before clinical deterioration sets in.