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International Journal of Current Microbiology and Applied Sciences (IJCMAS)
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NAAS Score: *5.38 (2019)
[Effective from January 1, 2019]
For more details click here

ICV 2018: 95.39
Index Copernicus ICI Journals Master List 2017 - IJCMAS--ICV 2018: 95.39
For more details click here

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PRINT ISSN : 2319-7692
Online ISSN : 2319-7706
Issues : 12 per year
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Editor-in-chief: Dr.M.Prakash
Index Copernicus ICV 2018: 95.39
NAAS RATING 2020: 5.38

Int.J.Curr.Microbiol.App.Sci.2018.7(6): 3068-3079
DOI: https://doi.org/10.20546/ijcmas.2018.706.361


Urinary Tract Infection among Children - A Study at a Tertiary Pediatric Care Hospital in Hyderabad, India
Ganga Bhavani1, B. M. Shanker Venkatesh1* and B. Venkatachalam2
1Department of Microbiology Osmania Medical College, Hyderabad, Telangana, India
2Department of Pediatrics, Apollo Medical College, Hyderabad, Telangana, India
*Corresponding author
Abstract:

Urinary tract infection (UTI) is considered as the most common bacterial infectious disease seen among the pediatric patients. Pediatric urinary tract infections are associated with high morbidity and long term complications like renal scaring, hypertension and chronic renal failure The epidemiology of UTI during childhood varies by age, gender and other factors (Bickerton and Ducket, 1985). Most commonly bacteria causes of UTI in children are members of Enterobacteriaceae, particularly uropathogenic strains of E. coli and Klebsiella spp. which are the primary causative pathogens of UTI in the different part of the world (Gautam et al., 2013). Susceptibility patterns of the bacterial isolates vary with geographic region and act as a reference for guiding the empirical therapy. The aetiology of paediatric UTI and the antibiotic susceptibility of urinary pathogens in both the community and hospitals have been changing, and drug resistance has become a major problem (Taneja et al., 2010). With this background, the present study was conducted to observe the profile of the paediatric UTI, to find out the bacterial pathogens involved and their antimicrobial susceptibility pattern at a tertiary paediatric care centre in Hyderabad, Telangana. This retrospective study was undertaken for a period of one year in the department of Microbiology, Institute of child health, Niloufer hospital a tertiary care paediatric hospital in Hyderabad Telangana. A total of 262 cases aged between 2months to 14 years clinically suspected of UTI, were studied over a period of One Year. The rapid diagnostic test using urocolor 10 strips (Standard Diagnostics Inc.) was performed on all the samples of urine and was correlated with conventional culture. Urine cultures were carried out on blood agar, Mac conkey, CLED agar and Hichrome UTI agar plates and the isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). Of the 262 children with suspected UTI included in this study, 100(38.16%) were found to be culture positive. Although urine culture is the standard criteria for diagnosis of UTI, it may take as long as 48 hours for culture to be positive. Hence the rapid diagnostic test using urocolor 10 strips (Standard Diagnostics Inc.) was performed on all the samples of urine and was correlated with conventional culture. Of the total 262 cases, 128 cases showed hematuria, 125 showed Leucocyte Esterase and 93 showed Nitrite test positive on the strip. Out of these the cultures were positive in 78 cases of hematuria, 97 cases of Leucocyte Esterase and 89 cases of Nitrite respectively The sensitivity of dipstick taken individually for hematuria, Leucocyte Esterase and Nitrite test were 60.93%, 77.6% and 95.69 % respectively. When all these parameters were taken combined the sensitivity was 78.07% and when taken for Leucocyte Esterase and Nitrite test was 86.65%. This confirms to the dipstick sensitivity of 85-90 %. In our study 87 samples showed growth with a single organism, while the total number of mixed infections were 13 (11%) out of which E.Coli + Enterococci were 4, Klebsiella + Enterococci 4, pseudomonas + candida 2 and E.Coli + CONS 3; An analyses of the results of present study reveals that amongst the various etiological agents isolated, Escherichia coli (55%) was found to be the most predominant organism in paediatric UTI,followed by klebsiella pneumoniae (26%)) The third in order of frequency was Enterococci which accounted for 10%.The other organisms isolated include Proteus mirabilis 2%, Pseudomonas aeriginosa 2%, Enterobacter 2%, Citrobacter 1% The present study reveals that most of the gram negative organism (GNB) were sensitive to Imipenem (95%), Amino glycosides 75%, Amoxyclav 60%, Piperacillin + Tazobactum 70% and 3rd generation cephalosporins 55%. The most resistant organism was pseudomonas which was sensitive only to Imipenam and piperacillin + Tazobactum. Pediatric urine culture isolates are becoming increasingly resistant to commonly used antibiotics. Finally, we suggest that empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organisms and antibiotic sensitivities rather than on universal guidelines.


Keywords: Urinary tract infection, Gram negative bacilli, Klebsiella, Antimicrobial susceptibility, Imipenem
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How to cite this article:

Ganga Bhavani, B. M. Shanker Venkatesh and Venkatachalam B. 2018. Urinary Tract Infection among Children - A Study at a Tertiary Pediatric Care Hospital in Hyderabad, India.Int.J.Curr.Microbiol.App.Sci. 7(6): 3068-3079. doi: https://doi.org/10.20546/ijcmas.2018.706.361