Abstract
BackgroundIn children, urinary tract infection (UTI) is one of a common bacterial infection. This study was conducted to detect the uropathogen, antimicrobial susceptibility, pathogen associated with recurrences and renal scarring in children initially taken care from general practitioners and later presented to tertiary care.MethodsEvery inward UTI episode, culture and antimicrobial susceptibility was done while on past 6-month, history of infections and use of antimicrobials was collected using clinical records and demonstration of antimicrobials. Children with recurrent pyelonephritis was followed and in vitro bio film formation was assessed.ResultsFrequency of UTI was significantly high among infants (p = 0.03). Last 6-month, all (220) were exposed to antimicrobials. Cefixime was the commonly prescribed antimicrobial (p = 0.02). In current UTI episode, 64.5% (142/220) of children with UTI were consulted GPs’ prior to seek treatment from tertiary care pediatric unit (p = 0.02). While on follow up child who developed UTI, found urine culture isolates were significantly shifted from E. coli and K. pneumoniae to extended spectrum of beta-lactamase (ESBL) E. coli and K. pneumoniae. Out of 208 participants, 36 of them had re-current pyelonephritis (R-PN). Renal scarring (RS) was detected in 22 out of 70 patients with pyelonephritis following dimercaptosuccinic acid scan. Following each episodes of recurrent pyelonephritis 11% of new scar formation was detected (p = 0.02). Bio film forming E. coli and K. pneumoniae was significantly associated in patients with R-PN (p = 0.04).DiscussionMedical care providers often prescribe antimicrobials without having an etiological diagnosis. While continuing exposure of third generation cephalosporin and carbapenem leads to development of ESBL and CRE microbes in great. The empiric uses of antimicrobials need to be stream lined with local epidemiology and antimicrobial susceptibility pattern. R-PN in childhood leads to RS. In great, bio film formation act as the focus for such recurrences.
Highlights
IntroductionUrinary tract infection (UTI) is one of a common bacterial infection
In children, urinary tract infection (UTI) is one of a common bacterial infection
We have found that, it was significantly associated with bio film forming E. coli and K. pneumoniae
Summary
Urinary tract infection (UTI) is one of a common bacterial infection. Urinary tract infection (UTI) is one of a common bacterial infection in children in world. It is much common among neonates and infants [1, 2]. In infants, is common among boys, thereafter the incidence is substantially rises in girls [3, 4]. Permanent renal scarring has been observed after UTI in 15–60% of affected children [8]. To minimize such insult the early diagnosis and targeted antimicrobial therapy is crucial [9]. To arrive at a microbiological diagnosis, Royal college of physicians (United Kingdom) guideline stated that clean catch urine in an infant or a mid-stream urine specimen in an older child is the ideal for urine culture
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