A study of bacteriological and antibiotic susceptibility profile of pediatric urinary tract infection with special emphasis on extended spectrum beta-lactamase production in a tertiary care hospital of Eastern India

• Published in: International journal of health & allied sciences 2016-10, Vol.5 (4), p.257-262
• Main Authors: Pal, Nupur, Rit, Kalidas, Naskar, Somnath, Kumar, Simit, Guhathakurata, Rajyasri
• Format: Article
• Language: English
• ISSN: 2278-344X; 2278-344X
• DOI: 10.4103/2278-344X.194129

Introduction: Urinary tract infection (UTI) is a common bacterial infection in children and associated with significant morbidity. Recently, UTI has become more difficult to treat because of the appearance of multidrug resistance pathogens. Objectives: The main aim of this study was to evaluate the changing trends of etiology, and antibiotic susceptibility pattern of urinary isolates in children of 0-12 year age group attending our hospital. Materials and Methods: A total of 930 urine samples were analyzed from children aged 0-12 years complaining of fever with or without urinary symptoms attending pediatric out- or in-patient of a tertiary care hospital from March 2011 to September 2012. In children under 2 years, urine sample was collected in a sterile bag and in above 2 years freshly passed clean-catch mid-stream urine was collected. All specimens were subjected to urine culture and sensitivity tests. Results: Significant bacteriuria was detected in 24.95% of patients. The most common pathogens isolated were Escherichia coli (60.34%), Klebsiella pneumoniae (20.63%), and Enterococcus spp. (5.17%). Extended spectrum beta-lactamase (ESBL) detection rate was low (3.77%). Most of the pathogens were susceptible to amikacin, piperacillin-tazobactam, nitrofurantoin, and imipenem. E. coli which was the main isolate was found to be most susceptible to imipenem (94.28%), amikacin (88.57%), nitrofurantoin (81.43%) and piperacillin-tazobactam (74.29%). Conclusion: This study reveals that most of the urinary isolates in pediatric age group are multidrug resistant, although ESBL detection rate is low. This suggests regular monitoring and modification of empirical therapy, and it should be validated by culture report to prevent morbidity associated with this disease.