Prevalence of Urinary Tract Pathogens and Antimicrobial Resistance Patterns in Children Aged 1 to 12 Years

Prevalence of Urinary Tract Pathogens and Antimicrobial Resistance Patterns in Children Aged 1 to 12 Years

Abstract 


Background: Urinary tract infections (UTIs) are counted among the most common infections in children. Most commonly, members of Enterobacteriaceae, particularly urinary pathogenic strains of Esch. coli and Enterobacter aerogenes are the primary causative organisms of UTIs in different parts of the world. In spite of the availability and use of the antimicrobial drugs, UTIs caused by bacteria have been showing increasing trends. Antibiotics are a mainstay in the treatment of bacterial infections, though their use is a primary risk factor for the development of antibiotic resistance. Antibiotic resistance is a growing problem in pediatric urology as demonstrated by increased urinary pathogen resistance. The extensive and inappropriate use of antimicrobial agents has invariably resulted in the development of antibiotic resistance which, in recent years, has become a major problem worldwide. Increasing antibiotic resistance among urinary pathogens to commonly prescribed drugs has become a global reality today. Complex pediatric patients with histories of hospitalizations, prior antibiotic exposure, and recurrent UTIs are also at high risk for acquiring UTIs due to extended spectrum beta-lactamase [ESBL] producing organisms. Data regarding the impact of in vitro antibiotic susceptibility testing interpretation on UTI treatment outcomes is lacking. The resistance of bacteria causing urinary tract infection (UTI) to commonly prescribed antibiotics is increasing both in developing as well as in developed countries. Resistance has emerged even to more potent antimicrobial agents.

Objective: To determine the prevalence and to find out the causative agents of UTI and their antibiotic resistance pattern among suspected UTI patients in children.

Methodology & Results: A total of 512 urine samples were collected from out patients of age between 1 to 12 years of both sex of children at Serum Analysis Center Pvt. Ltd. [Referral Laboratory]; Howrah; West Bengal; India between December 2016 to November 2017. The urine samples were cultured on HiCrome UTI Agra media and Eosin Methylene Blue Agar media [EMB] and the bacterial isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by Kirby Bauer disk diffusion method according to the current National Committee for Clinical Laboratory Standards (NCCLS) guidelines.

Among the 512 urine samples examined [1 to 12 years of children], included 276 (54.0%) in Male child & 236 (46.0%) in Female child and 220 (42.9%) of urinary pathogens are isolated. The bacteria were isolates 104 (37.7%) of male child and 116 (49.2%) of the female child. Inpatient of the male child, 50% of Esch. coli, 34.6% of Klebsiella pneumonia, 15.4% of others gram-negative bacilli and 52.0% Extended- spectrum Beta-lactamase [ESBL] stains were isolates. Inpatient of the female child, 72.4% of Esch. coli, 20.7% of Klebsiella pneumonia, 6.9% of others gram-negative bacilli and 58.7% Extended- Spectrum Beta-lactamase [ESBL] stains were isolates.

Resistance rates of Esch. coli [1 to 12 years of children] isolates were 83.8% to Amoxicillin/clavulanic acid, 70.5% to Cefixime, 23.5% to Fosfomycin, 26.5% to Nitrofurantoin, 63.2% to Ofloxacin, 66.1% to Ceftriaxone, 67.6% to Cefotaxime, 22.0% to Gentamicin, 89.7% to Cefpodoxime, 63.2% to Ciprofloxacin, 19.2% to Tobramycin, 80.8% to Cefprozil, 63.2% to Co-trimoxazole, 92.6% to Cefaclor, 70.5% to Doxycycline, 4.5% to Amikacin, 57.4% to Levofloxacin, 58.9% to Tetracycline and 89.8% to Cefalexin.

Comments

Post a Comment

Popular posts from this blog

Emergency Contraception Editorial Commentary

Image
Emergency Contraception Editorial Commentary Emergency contraception is the method of contraception that helps to prevent unintended and unplanned pregnancies after unprotected sex and before the implantation. This contraceptive method includes either the use of Emergency Contraceptive Pills (ECPs) levonorgestrel in a single dose 1.5mg, ulipristal acetate in a single pill containing 30mg or Copper-containing IUD s [1,2]. The recommendation timeframe to use the emergency postcoital contraception is as following: levonorgestrel pills should be taken within 72 hours, ulipristal acetate pills are indicated up to 120 hours and Copper-containing IUDs may be inserted intrauterine up to 5-7 days after unprotected intercourse respectively [1,2]. The exact mechanism of action of EC is not yet clear, but theoretically, it can affect follicle maturation, ovulation process, quality of cervical mucus, fertilization, zygote development and transport. Also, the mechanism of action varies depending
Read more

Extensive Amalgam Tattoo (Amalgam Pigmentation) on the Palatal Mucosa: A Case Report

Image
Extensive Amalgam Tattoo (Amalgam Pigmentation) on the Palatal Mucosa: A Case Report Abstract  Introduction : Amalgam tattoo is the most common exogenous oral pigmentation, caused by traumatic implantation of dental amalgam into soft tissue. Observation : We report a case of large amalgam pigmentation on the right hard palate. Discussion : Amalgam tattoo can sometimes be confused with melanotic lesions, being then biopsied. Once the diagnosis of amalgam tattoos has been established, the removal of lesions is not necessary, except for esthetic reasons. Keywords : Amalgam tattoo; Oral mucosa; Pigmentation. Introduction Oral pigmentations may be classified into two major groups on the basis of their clinical appearance: focal and diffuse pigmentations. All pigmented oral cavity lesions should be viewed with suspicion to eliminate a malignant melanoma. This article deals with an extensive amalgam tattoo lesion on palatal mucosa which required a biopsy for a definitive diag
Read more

Bioethics and Bioethical Education, Where to?

Image
Bioethics and Bioethical Education, Where to? Editorial To 12th World Conference Bioethics, Medical Ethics & Health Law, March 21-23, 2017, from Limassol, Cyprus, the conference president, Prof. Amnon Carmi showed that for the first fifty years of bioethics was discussed the construction and development of its bioethic concept and that we are now facing a second stage, a new task, that seems to be even more important, complex and difficult, namely the delivering of our message to society, by planting the ethical values into the soul of the people and into their daily life and behavior.  In bioethics are very important two different tools: educational tool that consist of the use of novel methods and a legal tool by translated and adopted of theory and language of bioethics by the legislator and the judiciary, e.g. the Universal Declaration of Bioethics and Human Rights of United Nations Educational, Scientific and Cultural Organization (UNESCO).  In actual society a
Read more