Abstract
Objective: This study aimed to detect and compare the frequency and antibiotics resistant pattern of Gram-negative uropathogens implicated in urinary tract infections (UTIs) in paediatric patients attending some hospitals in Nigeria and to proffer recommendations for its management. Methods: Based on standard procedures, midstream urine samples were collected. Urinalysis was done as a preliminary diagnosis of UTI using Combi-9 test strip. Isolation of uropathogen was done and antibiotic sensitivity test was carried out using Kirby-Bauer technique. Results: Out of 489 samples collected, 130 (26.4%) was positive for UTI. The prevalence rate of UTI in the investigated areas such as Nsukka, Otukpo, Gboko and Kastina Ala was 31.8%, 17.5%, 34.3% and 17.1%, respectively. The prevalence of UTI was higher in males 81 (30.9%) than in females 49 (21.6%), but there was no statistically significant association between gender and UTI (p = 0.636). The prevalence of UTI was greater among the age of 2 - 5 years (28.2%) and decreased with the increase in age, although there was no significant association between UTI and the age groups (p = 0.870). Generally, Klebsiella pneumonae (88.8%) was the most dominant bacterium (it was even more in males), followed by E. coli (40.6%), which was more in females, then Pseudomonas spp. (45.0%) and Proteus mirabilis (13.8%). The in-vitro antibiotic susceptibility testing shows that the isolate was highly resistant to Augmentin, Cotrimoxazoel, Amoxicilin and Tetracycline, while some of the isolate shows intermediate resistant to Nitrofurantoin and Nalixidic acid. Ofloxacine and Gentamicin were the most effective antibiotics against the isolates from all the study areas. The isolates had a varied range of MICs and MBCs. Conclusion: K. pneumonia predominated all isolates. The resistant patterns of the isolates to some of the antibiotics show that the first line of antibiotics for treatment of UTI in children in these areas is Ofloxacine and Gentamicin.
Highlights
Urinary tract infection (UTI) is regarded as one of the most serious infections caused by bacteria especially in children population
This study aimed to detect and compare the frequency and antibiotics resistant pattern of Gram-negative uropathogens implicated in urinary tract infections (UTIs) in paediatric patients attending some hospitals in Nigeria and to proffer recommendations for its management
The resistant patterns of the isolates to some of the antibiotics show that the first line of antibiotics for treatment of UTI in children in these areas is Ofloxacine and Gentamicin
Summary
Urinary tract infection (UTI) is regarded as one of the most serious infections caused by bacteria especially in children population. Apart from Staphylococcus aureus and Enterococcus, infections of bacteria are caused by members of the Enterobacteriaciae which include Escherichia coli, Proteus mirabilis, Klebsiella spp. and Pseudomonas aeruginosa [3] [4] [5]. It is worrisome of the pattern with which these bacterial pathogens resist commonly used antibiotics or antimicrobial agents [1]. For the UTI diagnosis to be confirmed in a laboratory prior to treatment, urine culture as well as testing for antibiotics sensitivity is usually done It challenges to collect uncontaminated urine samples from children and infants, who are not toilet trained [2] [8]. In treatment of UTI in children, there are no well-established antibiotics of choice since the sensitivity of the pathogens differs in several locations [9] [10]
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