PREVALENCE OF URINARY TRACT INFECTION IN PAEDIATRIC AGE GROUP AND THEIR ANTIBIOTIC SUSCEPTIBILITY

Abstract

Background: Urinary tract infections (UTIs) are one of the major causes of morbidity in paediatric population. Sound knowledge of factors associated with UTI may allow timely intervention that can easily bring the disease under control. This study was designed to determine the prevalence of UTI in pediatric age group and their clinical prole by isolating and characterizing the different bacterial agents and evaluate their antibiotic sensitivity. Materials and Methods:This prospective study was conducted in Department of Microbiology, AJ Institute of Medical Science & Research Center, Mangalore from May 2021 to April 2022. A total of 113 non repetitive urine samples (clean catch midstream urine, catheter aspirated, suprapubic aspirate) were collected from paediatric patients (0-18yrs) suspected of UTI. Culture and bacterial identication was done by using standard microbiological guidelines. Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method following clinical and laboratory standards institute (CLSI) guidelines. The study revealed a 27% Result: (31/113) UTI prevalence among paediatric patients attending hospital. Fever, irritability and poor feeding were the most common symptoms in neonates while older children presented with fever and urinary symptoms. The predominant organisms isolated were E. coli 15(48%) followed by Klebsiella spp 7(23%), Enterococcus spp 4(13%), Staphylococcus aureus 3(10%), Proteus 1(3%) and Pseudomonas aeruginosa 1 (3%). All isolates of E. coli were found to be sensitive to Meropenem 15 (100%), followed by Amikacin and Gentamicin and Co-trimoxazole 11(74%). Nitrofurantoin showed 94% sensitivity and Cephalosporins showed 94% resistance. Klebsiella spp were found to be sensitive towards Amikacin 7 (100%) followed by Cefoperazone 6 (85%) and showed resistance to Ceftazidime 6 (85%). ESBL producers in gram negative bacilli accounted for 38%. Enterococcus spp were found to be sensitive to Linezolid 4 (100%) and all showed resistance to Erythromycin, Penicillin, Tetracycline, Ciprooxacin and Noroxacin 4 (100%). Amikacin (11% resistance) and Nitrofurantoin (5% resistance) are the most effective drugs for gramnegative bacilli (GNB) while Vancomycin and Linezolid are functional against gram-positive cocci. The positivity rate from 0-6 years, 7- 12years, 13-18years were 11(35%), 3 (10%), 17 (55%) respectively. In our study, UTIs were more common in female (58%) children as compared to male (42%) children. Conclusions High-level antimicrobial resistance was observed in paediatric UTI with alarming incidence of superbugs like ESBL and MRSA. Regular surveillance should be carried out to determine the local prevalence of organisms and antimicrobial susceptibilities in order to guide the proper management of children.