PREDOMINANT ISOLATES OF UROPATHOGENS AND THEIR ANTIMICROBIAL SENSITIVITY IN FEBRILE CHILDREN ADMITTED TO EMERGENCY UNIT, TIKUR ANBESSA HOSPITAL

Muluwork Tefera, Damte Shimelis, Solomon Tessema

Abstract


Background: Diagnosis of urinary tract infection in children requires a high index of suspicion and optimal specimen collection method and processing for culture. This study was conducted to identify the common urinary tract pathogens and their susceptibility pattern in children at a teaching Hospital in Addis Ababa, Ethiopia.

Objectives- to identify the predominant urinary pathogens and their antimicrobial susceptibility pattern in children admitted with fever and no other source of infection

Methods- This cross sectional study was conducted from April 2015-July 2016 in children between 0-15 years of age who were admitted to the emergency unit of the Department of Pediatrics with fever and no other source of infection. Antimicrobial sensitivity was determined according to laboratory standards.  

Results: A total of 237 children were admitted with fever and no other source of infection. There were 46 urine culture positives of single organisms (19.4%). The most common organisms isolated were Eschericha.coli in 50% and Klebsiella species in 37%. Escherichia coli was resistant to gentamycin in 60.9%; ceftriaxone 79.6%, and ampicillin 95.7%. Klebsiella was 100% resistant to ampicillin, cotrimoxazole and augmentin.

Conclusion: A high rate of urinary tract infection and resistance compels area specific surveillance to select the appropriate antibiotic for empirical treatment of urinary tract infection in children.

Key words: Pediatrics, emergency unit, urinary tract infection, young infant

 


Full Text:

PDF

References


Winberg J. Epidemiology of symptomatic urinary tract infections in childhood. Acta Paediatr Scand Suppl. 1974; 252:1-20.

Jack S. Elder. Urinary tract infections. Nelson Text Book of Pediatrics 20th edn. Kleigman et al eds. Saunder Elsevier, Philadelphia. pp 2556-61.

Dagan R, Einhorn M, Lang R, et al. Once daily cefixime compared with twice daily trimethoprim/sulfamethoxazole for treatment of urinary tract infection in infants and children. Pediatr Infect Dis J. 1992; 11:198-203.

Committee on Quality Improvement, Subcommittee on Urinary Tract Infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics. 1999; 4:843-52.

Lutter SA, Currie ML, Mitz LB, Greenbaum LA. Antibiotic Resistance Patterns in Children Hospitalized for Urinary Tract Infections. Arch Pediatr Adolesc Med. 2005; 159:924-8.

Bachur R, Caputo G. Bacteremia and meningitis among infants with urinary tract infections. Pediatr Emerg Care. 1995; 11:280-4.

Shapiro ED. Infections of the urinary tract. Pediatr Infect Dis J. 1992; 11:165-8.

Nelson DS, Gurr MB, Schunk JE. Management of febrile children with urinary tract infections. Am J Emerg Med. 1998; 16:643-7.

Hellerstein S. Urinary tract infections: old and new concepts. Pediatr Clin North Am. 1995; 42:1433-57.

Hoberman A, Wald E, Hickey RW, et al. Oral versus initial intravenous therapy for urinary tract infections in young febrile children. Pediatrics. 1999; 104:79-86.

Moges F, Genetu A, Mengistu G. antibiotic sensitivity of common bacterial pathogens in urinary tract infection at Gondar Hospital, Ethiopia. East Afr Med J. 2002;79: 140-2

Tessema B, Kassu A, Mulu A, Yismaw G. Predominant isolates of urinary tract pathogens and their antimicrobial susceptibility patterns in Gondar University Teaching Hospital, North West Ethiopia. Ethiop Med J.2007; 45(1):61-7

Wolday D, Erge W. Increased incidence of resistance to antimicrobials by urinary pathogens isolated at Tikur Anbessa Hospital. Ethiop Med J. 1997; 35(2):127-35

Tadesse A, Negash M, Ketema S. Asymptomatic Bacteriuria in pregnancy: Assessment of prevalence, Microbial agents and their antimicrobial sensitivity pattern in Gondar Teaching Hospital, North west Ethiopia. Ethiop Med J. 2007; 45(2):143-9

Enenkel S, Stille W. Antibiotics in the Tropics, 1st ed. Berlin, Springer Verlag, 1988.

Prais D, Straussberg R, Avitzur Y, Nussinovitch M, Harel L, Amir J. Bacterial susceptibility to oral antibiotics in community acquired urinary tract infection. Arch Dis Child. 2003; 88:215-8.

Ashkenazi S, Even-Tov S, Samra Z, Dinari G. Uropathogens of various childhood populations and their antibiotic susceptibility. Pediatr Infect Dis J. 1991; 10:742-6.

Goldraich NP, Manfroi A. Febrile urinary tract infection: Escherichia coli susceptibility to oral antimicrobials. Pediatr Nephrol. 2002; 17:173-6.

Murray BE, Rensimer ER, DuPont HL. Emergence of high-level trimethoprim resistance in fecal Escherichia coli during oral administration of trimethoprim or trimethoprim-sulfamethoxazole. N Engl J Med.1982; 306:130-5.

Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. American Academy of Peediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Pediatrics 1999; 103: 843-52

Zorc J J, Kiddoo D A, Shaw KN. Diagnosis and Management of Pediatric Urinary Tract Infections. Clin. Micriobiol. Rev. 2005; 18 (2): 417-22

Shaikh N, Morone N E, Bost J E. Prevalence of Urinary Tract Infection in Childhood. A Meta- Analysis. The Pediatric Infectious Disease Journal 2008; 27(4):1-7

Suneetha N, Subbulu P, Rani S.U.V, Reddy B.K. Bacteriological Study of Urinary Tract Infection. International Journal of Interdisciplinary and Multidisciplinary Studies (IJIMS) 2015; 2 (4):11-6

Wu C-T, Lee H-Y, Chen C-L, Tuan P-L, Chiu C-H. High prevalence and antimicrobial resistance of urinary tract infection isolates in febrile young children without localizing sins in Taiwan. Journal of Microbiology, Immunology and infection 2016; 49: 243-8.


Refbacks

  • There are currently no refbacks.


Kirkos Sub-City, Woreda 05
Roosevelt street, Infront of Africa Union main gate
Tel: +251 115 533742 Fax: +251 115 151005
P.O.Box 2179 Email: info@emaemj.org
Copyright © Ethiopian Medical Association 2018 All rights Reserved

Powered by OJS & Designed and Hosted by MAKE Enterprise