Citrobacter Emerging as a Common Uropathogen in Pediatric Population
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 4
Abstract
Introduction: There is a changing scenario of the epidemiology of uropathogen in the hospital setup. Citrobacter species being the inhabitants of intestinal tract is emerging as one of the leading uropathogens in pediatric age group. Purpose: The study was undertaken to look for the prevalence of Citrobacter species responsible for uropathogen with its antibiogram, in pediatric age group. Materials and Methods: A cross-sectional study was carried out over a period of 1½ year. A total of 1890 clean-catch midstream urine samples were processed in clinical microbiology laboratory during the study period. Isolates were identified using standard isolation methods, and antibiogram was done using Kirby–Bauer diffusion method as per the Clinical and Laboratory Standards Institute guidelines. Extended-spectrum beta-lactamase (ESBL), metallo-beta‑lactamase, and AmpC were tested for the multidrug-resistant (MDR) isolates. Results: 90% belonged to Gram-negative pathogens, among which highest growth isolated was Escherichia coli 289 (41%) followed by Citrobacter spp. 122 (17.3%) and Pseudomonas spp. 105 (15%). Antibiograms of Citrobacter spp. isolates revealed that effective agent against Citrobacter spp. isolates was imipenem (89.7% sensitive), followed by amikacin (85.4%), gentamicin (72%), and piperacillin/tazobactam (68.4%). Among oral drugs, most sensitive is levofloxacin (52%) and nitrofurantoin (51.2%). Of the 122 strains in pediatric population, 74 (61%) were found to be MDR of which 62 (51%) were ESBL producers and 81 (66.4%) were AmpC producers. Conclusion: Our study showed that the prevalence of Citrobacter as a uropathogen in pediatric population has increased becoming the 2nd most common uropathogen (17.3%). The Citrobacter isolates resistant to multiple antimicrobial agents have emerged, making it an emerging nosocomial pathogen. In pediatric age group, urinary tract infection soon progresses to urosepsis and renal damage, so search for this pathogen as well as its antibiogram is essential. Adoption of hospital infection control practices and a good antibiotic policy may prevent their spread.
Authors and Affiliations
Ritu Kumari, Jayanta Bikash Dey, Anshuman Jana, Tapashi Ghosh, Nikhil Kumar Tudu
Keywords
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