Serotyping and Antimicrobial Susceptibility Pattern of Escherichia coli Isolates from Urinary Tract Infections in Pediatric Population in a Tertiary Care Hospital.

Shweta Sharma,Wasim Ahmad,Charoo Hans,Nirmaljit Kaur,Shalini Malhotra,Preeti Madan

doi:10.1155/2016/2548517

Abstract

Urinary tract infections (UTIs) in pediatric population are associated with high morbidity and long term complications. In recent years, there is increased prevalence of Escherichia coli (E. coli) strains producing extended spectrum β-lactamase, Amp C, and Metallo β-lactamase, making the clinical management even more difficult. This study was aimed to detect the serotypes and to determine antimicrobial susceptibility profile of E. coli isolates from urine samples of children <10 yrs old. A total of 75 pure E. coli strains isolated from patients with symptoms of UTI and colony count ≥105 organisms/mL were included in the study. Antibiotic sensitivity pattern showed maximum resistance to nalidixic acid (98.7%), followed by ampicillin (97.3%), amoxi-clavulanate (96%), and fluoroquinolones (92%) while most of the isolates were found sensitive to piperacillin-tazobactam (13.3%), nitrofurantoin (5.3%), and meropenem (1.3%). 48% of the strains were ESBL producer (extended spectrum beta lactamase). 44% strains were typable withantisera used in our study and the most common serogroup was O6 (33.3%) followed by O1 (15.1%) and O15 (15.1%). To conclude, judicious use of antibiotics according to hospital antibiotic policy and infection control measures should be implemented to prevent spread of multidrug resistant organisms.

Highlights

Urinary tract infections (UTIs) are one of the most common infections encountered in the clinical practice, and in pediatric population it is associated with high morbidity and long term complications like renal scarring, hypertension, and chronic renal failure [1]
E. coli that are associated with UTI are commonly named uropathogenic isolates, there is evidence that different pathotypes may be related to UTI; uropathogenic E. coli (UPEC) is responsible for approximately 90% of all UTIs [3]
Out of seventy-five E. coli strains isolated from children, male : female ratio was found to be 1.2 : 1 with 54.7% of the patients being males. 66.7% of the isolates were derived from admitted patients while 33.3% of the patients came to OPD with symptoms of UTI. 54.7% of the isolates were from ward patients followed up by OPD (33.3%) and ICU (12%) (Table 1)

Summary

Introduction

Urinary tract infections (UTIs) are one of the most common infections encountered in the clinical practice, and in pediatric population it is associated with high morbidity and long term complications like renal scarring, hypertension, and chronic renal failure [1]. In UPEC, the O-serogroups are related to the virulence factor profile of each strain. Previous studies reported that O1, O2, O4, O6, O7, O8, O15, O16, O18, O21, O22, O25, O75, and O83 serogroups are preferentially associated with UPEC strains [4, 5]. Clinicians must be aware of Journal of Pathogens the susceptibility patterns of UPEC strains in their specific geographical populations to optimize the use of empirical antibiotic therapy for UTIs. This study was aimed to detect the serotypes and to determine antimicrobial susceptibility profile of E. coli isolates from urine samples of children less than 10 yrs old

Objectives

Methods

Results

Conclusion