Antibiotic resistance of urinary tract pathogens and rationale for empirical antibiotic therapy in children with urinary tract infection
Background and objective: Increased antimicrobial resistance of urinary tract pathogen is a matter of global public health concern. The purpose of this study was to identify the most common bacteria causing urinary tract infection and detection of antibiotics susceptibility of isolates to evaluate the options for empirical antibiotic therapy in children with urinary tract infection in Erbil city.
Methods: This study was conducted in Raparin Teaching Hospital on urine samples culture results over a one year period retrospectively. Hospital microbiology recording book was screened. Throughout the study period, 1622 children suspected to have urinary tract infection were investigated for urine culture. Disc diffusion technique according to clinical and laboratory standards institute (CLSI) was performed to determine antibiotics susceptibility of isolated bacteria species.
Results: Of 1622 children with suspected urinary tract infection, 514(31.69%) had a positive bacterial culture that included 104 males and 410 females. The most common isolates were E Coli (54.1 %), Staphylococcus (19.1%) and Proteus (12.5%). The most effective antibiotics against isolated pathogens were imipenem, ciprofloxacin and nitrofurantoin with sensitivity rate 95.2%, 78.8% and 74.1% respectively.
Conclusion: This study revealed that E. coli and staphylococcal strains were the most frequent isolated pathogens among our population; empirical antibiotic selection should be based on the knowledge of the local prevalence of bacterial organism and antibiotic sensitivity.
Echeverri CV, Serna-Higuita LM, Serrano AK, Garcia CO, Rosas LR, Bedoya AM, et al. Profile resistance of pathogens causing urinary tract infection in pediatric population and antibiotic treatment response at a university hospital 2010-2011. Colombia Medica 2014; 45(1):39-44.
Kaur N, Sharma S, Malhorta S, Madan P, Hans C. Urinary tract infection: aetiology and antimicrobial resistance pattern in infant from a tertiary care hospital in northern india. J ClinDiagnRes 2014; 8(10):1-3.
Prais D, Straussberg R, AvitzurY, Nussinovitch M, Harel L, Amir J. Bacterial susceptibility to oral antibiotics in community acquired urinary tract infection. Arch Dis Child 2003; 88(3):215-8.
Gupta S, Kapur S, Padmavathi DV. Comparative Prevalence of Antimicrobial Resistance in Community-Acquired Urinary Tract Infection Cases from Representative States of Northern and Southern India. J ClinDiagn Res 2014; 8(9): 9-12.
Das RN, Chandrashekhar TS, Joshi HS, Gurung M, Shrestha N, Shivananda PG. Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal. Singapore Med J 2006; 47(4): 281-5.
Hussein NS. Clinical, Etiology and Antibiotic Susceptibility Profiles of Community-Acquired Urinary Tract Infection in a Baghdad Hospital. Med SurgUrol 2014; 3:136.
Ghorashi Z, Ghorashi S, Soltani-Ahari H, Nezami N. Demographic features and antibiotic resistance among children hospitalized for urinary tract infection in northwest Iran. Infect Drug Resist 2011; 4:171-6.
ÇobanB, Ülkü N, Kaplan H, Topal B, Erdoğan H, Baskın E. Five year assessment of causative agents and antibiotic resistances in urinary tract infections.TurkPediatriArs 2014;49:124-9.
Report on population estimate 2009-2020. Kurdistan Region Statistics Office; 2014.
CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard—Eleventh Edition. CLSI document M02-A11. Wayne, PA: Clinical and Laboratory Standards Institute; 2012.
Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in JNMC Hospital Aligarh, India.Ann ClinMicrobiolAntimicrob 2007; 23:6:4.
Waheda N, albazzaz PH, Mansoor EY, Toma S. Certain virulence characteristics of common bacteria involved in urinary tract infection in Erbil setting. Zanco J Med Sci 2010; 14(1):1-7.
Al Marzoqi AH. Etiology and antimicrobial sensitivity of common uropathogens in Hilla infants. Medical Journal of Babylon 2008; 5:3-4.
Saeed CH, Al Otraqchi KI, Mansoor IY. Prevalence of urinary tract infection and antibiotics susceptibility pattern among infants and young children in Erbil city. Zanco J Med Sci 2015;19 (1):915-22.
Al Madani TA, Hashim JM. Prevalence of bacterial agentscausing urinary tract infection in children below 5 years of age and their antibiotic sensitivity. Thi-Qar Med J (TQMJ) 2007;1(1): 75-82.
Ramlakhan S, Singh V, Stone J, Ramtahal A. Clinical Options for the Treatment of Urinary Tract Infections in Children, Clin Med Insights Pediatr 2014; 8:31-7.
Wachter DA1, Joshi MP, Rimal B. Antibiotic dispensing by drug retailers in Kathmandu, Nepal.Trop Med Int Health 1999; 4(11):782-8.
Larsson M, Kronvall G, Chuc NT, Karlsson I, Lager F, Hanh HD, et al. Antibiotic medication and bacterial resistance to antibiotics: a survey of children in a Vietnamese community.Trop Med Int Health 2000;5(10):711-21.
Sharma A, Shrestha S, Upadhyay S, Rijal P. Clinical and bacteriological profile of urinary tract infection in children at Nepal Medical College Teaching Hospital.Nepal Med Coll J 2011;13(1): 24-6.
Grover SS1, Sharma M, Chattopadhya D, Kapoor H, Pasha ST, Singh G. Phenotypic and genotypic detection of ESBL mediated cephalosporin resistance in Klebsiellapneumoniae: emergence of high resistance against cefepime, the fourth generation cephalosporin. J Infect 2006; 53(4):279-88.
Yüksel S, Öztürk B, Kavaz A, Özçakar ZB, Acar B, Güriz H, et al. Antibiotic resistance of urinary tract pathogens and evaluation of empirical treatment in Turkish children with urinary tract infections. Int J AntimicrobAgents 2006; 28(5): 413-6.
Rawat D, Nair D. Extended-spectrum β-lactamases in Gram Negative Bacteria J Glob Infect Dis 2010;2(3):263-74.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).