Antibiotic Resistance in Community Acquired Urinary Tract Infection in Children: Data from a Tertiary Center in Eastern India
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 1
Abstract
ABSTRACT Introduction: Antibiotic resistance is an increasing global problem which hampers appropriate treatment of Urinary Tract Infection (UTI) in paediatric population, rendering the developing kidneys vulnerable for scarring and long-term complications. The present study stressed upon the most severely affected patients who required hospitalisation for treatment of UTI. Authors conducted this study observing the higher degree of drug resistance in patients admitted to general paediatric ward lately, suffering from UTI. Aim: To observe different clinical presentations of paediatric patients hospitalised with UTI. Authors also intended to identify locally prevalent community acquired bacterial uropathogens of clinical importance and note the sensitivity and resistance patterns of the isolated organisms against different antibiotics. Materials and Methods: This prospective observational pilot study was conducted at the Institute of Child Health, Kolkata, a tertiary care paediatric referral hospital. A total of 950 urine samples (single sample per patient) were collected from hospitalised children (from neonatal age group, upto 12 years) with suspected UTI/sepsis, between October 2014 to April 2016. Of 132 culture positive samples, 35 were excluded as per exclusion criteria, and 97 isolates had antimicrobial sensitivity performed on them. Clinical presentation was documented. Statistical analysis was done using the Chi-Square test. Results: The most common clinical presentations were fever, pain abdomen and anorexia. The most common isolates were Escherichia coli 59/97 (60.82%), followed by Enterococcus spp. 19/97 (19.59%) and Klebsiella pneumoniae 9/97 (9.28%). The majority of E. coli (n=59) isolates showed resistance against all Cephalosporins: 49-52 (83.1-88.1%), meropenem: 39 (66.1%), cotrimoxazole: 42 (71.1%), amoxycillin-clavulanic acid: 55 (93.2%) and quinolones: 50-51 (84.8-86.4%). Most Enterococcus spp. (n=19) isolates were resistant to amikacin: 17 (89.5%). Overall, a large proportion, 79/97 (81.4%) of uropathogens isolated showed Multidrug-Resistance (MDR). Conclusion: The alarming rates of resistance of uropathogens to commonly used antibiotics calls for review of empiric treatment guidelines and emphasises the need for preventing antibiotic misuse in day-to-day practice.
Authors and Affiliations
Aniruddha Ghosh, Sumon Poddar, Sushmita Banerjee, Jaydeep Choudhury, Maya Mukhopadhyay, Jaydeb Ray
Keywords
Related Articles
- EP ID EP523925
- DOI 10.7860/JCDR/2018/30228.11106
- Views 48
- Downloads 0
Volumetric Analysis of the Jaws in Skeletal Class I and Class II Patients using CBCT and Derived Lateral Cephalograms
Introduction: Cone Beam Computed Tomography (CBCT) imaging recently has become a very common diagnostic tool in the orthodontic literature. Recent research work has shown that CBCT imaging would give additional informati...
Hair Loss in Paediatric and Adolescent Age Group: A Clinico-Pathological Analysis in a Tertiary Health Care Centre
Introduction: Hair loss in children causes deep distress to both the child and the parent. The most common causes of paediatric alopecia are tinea capitis, alopecia areata, traction alopecia and trichotillomania. Timely...
Surgical Management of a Rare Case of Massive Compound Odontome Associated with Missing Primary Tooth
Odontomes are considered to be the most common odontogenic tumours of the jaws. They are benign, mixed tumours arising from the remnants of both odontogenic epithelium and the ectomesenchyme resulting in the deposition o...
Invasive Cystic Hypersecretory Carcinoma of Breast: A Rare and Under Diagnosed Variant of Ductal Carcinoma
Handful cases of invasive Cystic Hypersecretory Ductal Carcinoma (CHC) have been reported so far in literature. Cystic hypersecretory lesions of breast have a spectrum of morphological features ranging from Cystic Hypers...
Effect of Passive, Active and Combined Warm up on Lower Limb Muscle Performance and Dynamic Stability in Recreational Sports Players
Introduction: Warm up is an activity that is done before a sports activity. The warm up can be done actively and passively. The preferred mode is active warm up in athletes. There are inconclusive effects of passive warm...