Abstract
Urinary tract infections (UTIs) are one of the most common types of infections in children. Resistance to drug used in UTI is universal crisis in the present world. UTIs are usually caused by bacteria living on or in our bodies, and require treatment with antibiotics. A prospectively observational study was conducted in Kurmitola General Hospital (KGH) from January 2018 to December 2018. A total of 519 culture positive UTI children were considered for analysis. Colony counts for these samples were identified, and the profile of antibiotic resistance was identified. Here, samples with a colony count of ≥105 CFU/mL bacteria were considered positive. Among the children 416 children took antibiotics without prescription and among them 205 (49.2%) was culture positive. The most common pathogen was E-coli (74.31%) which prevailed that taking antibiotics without prescription is highly associated with the drug resistant UTI recurrent abdominal pain. Researcher took 19 antibiotics for susceptibility testing to identify the most resistant and safe drug for the UTI patients. According to the present study sensitive antibiotics were Cephradine 0%, Cefotaxim 0%, Imepenam 100%, Cotrimoxale 46%, amoxicillin and clavulanic acid 0%, Cefixime 36%, Cefuroxime 19%, Ceftriaxone 22%, Azithromycin 25%, Nitrofurantoin 66%, Ceftazidime 19%, Ciprofloxacin 47%, Nalidixic acid 36%, Levofloxacin 71% Colistin 79%, Gentamycin 80%, Netilmycin 80%, Amikacin 80% and Meropenam 40%. On the other hand, resistance was Cephradine 100%, Cefotaxim 100%, Imepenam 0%, Cotrimoxale 54%, Amoxicillin and clavulanic acid 100%, Cefixime 64%, Cefuroxime 81%, Ceftriaxone 78%, Azithromycin 75%, Nitrofurantoin 34%, Ceftazidime 81%, Ciprofloxacin 53%, Nalidixic acid 64%, Levofloxacin 29%, Colistin 21%, Gentamycin 20%, Netilmycin 20%, Amikacin 20% and Meropenam 60%. So, the most sensitive drug was Imepenam 100% and the most resistant drugs were Cephradine and Cefotaxim 100% resistance against urinary pathogens. Association between antibiotic use, drug resistance and use of with and without prescription in UTI patients was highly significant. We suggest that empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organism and their antibiotic resistance in a specific area rather than on universal or even national guidelines.
Highlights
The prevalence of Urinary tract infections (UTIs) varies with the ages of the children
The study participants were divided into two groups on the basis of taking antibiotics with the prescription provided by the registered physicians and without prescriptions by self and other means
Constant survey of antimicrobial resistance is very important for empirical treatment of UTI. [13,14]This study showed drug resistant UTI presented as recurrent abdominal pain in younger children is highly associated with frequently use of antibiotics without prescription through a survey with a number of 519 pre-school and school going children
Summary
The prevalence of UTI varies with the ages of the children. It occurs in children of all ages. UTI are the most common in children under one year at age. The prevalence of a febrile symptomatic UTI in children over one year is 8% and in febrile infant is 7%. Male female ratio in 1st year of life is. 2.8:5.9 and beyond 1-2 year male female ratio is 1:10 that is female more predominant. UTI in male is more common in 1st year of life and in uncircumcised male. UTI causes end stage renal failure in 2% cases. Without specific prescription resulting in a partially treated UTI. UTI (urinary tract infections) causes scaring the dysplasia
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