scholarly journals Prevalence and Antimicrobial Susceptibility of Bacterial Uropathogens Isolated from Pediatric Patients at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yamirot Merga Duffa ◽  
Kumera Terfa Kitila ◽  
Dereje Mamuye Gebretsadik ◽  
Adane Bitew
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Pediatric Patients ◽  
Multidrug Resistant ◽  
Bacterial Isolates ◽  
Coagulase Negative Staphylococci ◽  
E Coli ◽  
Significant Bacteriuria

Background. Urinary tract infection (UTI) is considered as the most common bacterial infection seen among the pediatric patients. Objective. This study was carried out in order to determine the prevalence of urinary tract infection in pediatric patients, identify bacterial uropathogens responsible for the infection, and study the antibiotic sensitivity patterns of bacterial isolates. Materials and Methods. A cross-sectional study designed and conducted from January to April 2014. Clean-voided midstream urine specimens were obtained from 384 pediatric patients less than or equal to 15 years in sterile universal bottles. Urine collected from each patient was inoculated onto CLED and blood agar plates using a calibrated inoculating loop with a capacity of 0.001 ml. Inoculated plates were incubated for 24–48 hours at 37°C at inverted position aerobically. Bacterial isolates were indentified and characterized by Gram stain and by using an array of standard routine biochemical tests. The antimicrobial susceptibility test was carried out by using the Kirby–Bauer disc diffusion method. Frequency distribution tables were used to describe the findings. Logistical regression was also used to estimate crude odds ratio (COR) with 95% confidence interval (CI) of positive responses to the different variables, and P values less than 0.05 were taken as statistically significant. Result. In this study, a total of 384 patients (199 males and 185 females) aged less than or equal to 15 years from whom urine samples were collected were enrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36 (19.5%) came up with positive cultures, while 25 (12.6%) of the 199 males had significant bacteriuria, and the largest number of study subjects were below the age of 3 years, and the largest positive culture was obtained from this age group, accounting for 35 (57.4%.) out of 61 positive cultures. Bacterial species belonging to six genera were isolated and identified from 61 positive cultures, and the genera were Escherichia, Klebsiella, Staphylococcus, Proteus, Acinetobacter, and Enterococcus. E. coli was isolated in 28 cases (49.5 %), followed by Klebsiella spp. in 17 cases (27.9%), Staphylococcus spp. in 5 patients (8.2%.) (S. aureus in one and coagulase-negative staphylococci in 4 cases), Enterococcus in 7 cases (11.5%), Proteus spp. in 3 cases (4.9%), and Acinetobacter in one case (1.6%). Of the bacterial isolates, E. coli was found out to be the most common pathogen followed by Klebsiella spp. Furthermore, E. coli and Klebsiella spp. were the most common pathogens in female patients accounting for 71.4% and 64.7%, respectively. Regarding susceptibility tests, E. coli and Klebsiella spp. were not 100% susceptible to any of the 11 antibiotics tested. Acinetobacter spp. had 100% resistance to three antibiotics: gentamicin (GN), trimethoprim-sulfamethoxazole (SXM), and augmentin (AMP). But they were 100% susceptible to ciprofloxacin (CIP), cefuroxime (CXM), norfloxacin (NOR), and ceftazidime (CAZ). On the contrary, Proteus spp. was 100% sensitive to all drugs except to nitrofurantoin. Species of Enterococcus had resistance of 71.4% to chloramphenicol (C) and 85.7% to both SXM and erythromycin. S. aureus was 100% susceptible to almost all drugs, while coagulase-negative staphylococci were not as susceptible as S. aureus. Multidrug resistance to two or more drugs was observed in 73.7% of the bacterial isolates. Conclusion. This study determined the prevalence of urinary tract infection in pediatric patients and highlighted the major bacterial uropathogens involved in UTI for the first time in the country. Furthermore, bacterial pathogen species and their frequency was consistent with the usually reported pattern, with E. coli being the most common organism isolated in cases of urinary tract infections followed by Klebsiella spp. Most of the bacterial isolates were multidrug resistant, and it is therefore suggested that appropriate antimicrobials should be administered to reduce the risk of multidrug resistant organisms developing and avert ineffectiveness of antibiotics. This condition indicates that antibiotic selection should be based on knowledge of the local prevalence of bacterial organisms and antibiotic sensitivities rather than empirical treatment. The present study indicated that ciprofloxacin (CIP), ceftazidime (CAZ), cefotaxime (CTX), cefuroxime (CXM), clindamycin (DA), and ceftriaxone (CRO) were the best antibiotics for the treatment of Gram-negative and Gram-positive bacterial uropathogens, respectively, in the study area relatively.

scholarly journals Prevalence, Antimicrobial Susceptibility Pattern of Bacterial Isolates, and Associated Factors of Urinary Tract Infections among HIV‐Positive Patients at Hiwot Fana Specialized University Hospital, Eastern Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Dadi Marami ◽  
Senthilkumar Balakrishnan ◽  
Berhanu Seyoum
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
University Hospital ◽  
Hiv Positive ◽  
Bacterial Isolates ◽  
E Coli ◽  
Antimicrobial Susceptibility Pattern ◽  
Tract Infections

Urinary tract infection remains a major public health problem in developing countries, where there are limited health-care services. Its prevalence is fueled by human immunodeficiency virus (HIV) infection. The emergence of antimicrobial resistance is now widespread and poses a serious clinical threat. This study investigated the prevalence, antimicrobial susceptibility pattern of bacterial isolates, and associated factors of urinary tract infections among HIV-positive adult patients. A cross-sectional study was conducted among 350 randomly selected HIV-positive patients at Hiwot Fana Specialized University Hospital from February to March 2016. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were collected aseptically and examined using the recommended culture methods. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion technique. Data were analyzed using Statistical Package for the Social Sciences version 21.0. The logistic regression models were used to explore the predictors of the outcome. A p value < 0.05 was considered statistically significant. The overall prevalence of urinary tract infection was 18% (95% CI: 15.34–22.63). Individuals with age 35–44 years (Adjusted odds ratio (AOR): 4.07; 95% CI: 1.09, 5.10), income less than 46.7 USD (AOR: 2.76; 95% CI: 1.15, 6.07), and a CD4+ count less than 200 cells/mm3 (AOR: 2.07; 95% CI: 1.15, 3.73) had higher odds of UTI. Escherichia coli (38.1%), Klebsiella pneumoniae (23.8%), and Staphylococcus aureus (11.1%) were the predominant causes of urinary tract infection. E. coli was resistant to ampicillin (95.8%), ceftazidime (95.8%), cotrimoxazole (95.8%), amoxicillin (91.7%), ceftriaxone (87.5%), and tetracycline (87.2%). Multidrug resistance was observed in 46% of the isolates. The prevalence of urinary tract infection in this study was high compared to the previous reports in Ethiopia. Age 35–44 years, income less than 46.7 USD, and a CD4+ count < 200 cells/mm3 increase the odds of urinary tract infection. The most common isolates were E. coli, K. pneumoniae, and S. aureus. Almost half of the isolates were multidrug resistant. Actions to help mitigate the further spread of resistance are urgently needed in the study area.

scholarly journals Bacteriological profile, risk factors and antimicrobial susceptibility patterns of symptomatic urinary tract infection among students of Mekelle University, northern Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guesh Gebremariam ◽  
Haftom Legese ◽  
Yemane Woldu ◽  
Tadele Araya ◽  
Kiflom Hagos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Medical Attention ◽  
Bacterial Isolates ◽  
Symptomatic Urinary Tract Infection ◽  
Mekelle University ◽  
History Of

Abstract Background Bacterial infection of the urinary tract is among the common reasons for seeking medical attention in the community. Rapidly increasing antibiotic resistance of uropathogens is resulting in limited treatment options. Therefore, knowledge of the current uropathogens and their antibiotic susceptibility is important for better treatment of urinary tract infection. Methods A cross-sectional study design was conducted from February to September thirty, 2017 among students who came to Mekelle University student’s clinics with symptomatic urinary tract infection during the study period.. Mid-stream urine specimens were collected from 341individuals with suspected urinary tract infection for bacteriological identification and antimicrobial susceptibility testing. Data on socio-demographic, clinical and risk factors were also collected using a structured questionnaire. Results Among the 341 study participants, 72(21.1%) showed significant bacteriuria. Escherichia coli (48.6%), Coagulase-negative staphylococci (23%), Staphylococcus aureus (13.5%), and Klebsiella spp. (8.1%) were common bacterial isolates. Resistance to ampicillin (81–100%), amoxicillin/clavulanic acid (77–93.6%), co- trimoxazole (55 72.3%), nalidixic acid (57.4%) and tetracycline (46–55.5%) was seen by most isolates. Multidrug resistance was observed in 73% of the bacterial isolates, and 25.5% of the Gram-negative isolates were extended-spectrum beta-lactamase producers. Being female, a history of urinary tract infection, a history of catheterization and frequent sexual activity were found to be statistically associated with urinary tract infection. Conclusion Urinary tract infection is a problem among university students with a prevalence of 21.1%. All isolates have developed resistance to most of the commonly used antibiotics. Therefore, health education on the transmission and causes of urinary tract infection are recommended for the students.

scholarly journals Biofilm Production and Antimicrobial Resistance among Uropathogens in Pediatric Cases: a Hospital Based Study

2018 ◽  
Vol 16 (2) ◽  
pp. 178-183
Author(s):  
Dhiraj Shrestha ◽  
Pratigya Thapa ◽  
Dinesh Bhandari ◽  
Hiramani Parajuli ◽  
Prakash Chaudhary ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Tract Infection ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
E Coli ◽  
Biofilm Production ◽  
Resistance Patterns

Background: The study was designed to provide account of etiological agents of urinary tract infection in pediatric patients and the antimicrobial resistance pattern plus biofilm producing profile of the isolates.Methods: The prospective study was conducted in Alka Hospital, Nepal with 353 clean catch urine samples from children. It was obtained during July 2014 to January 2015 which were first cultured by semi-quantitative method, followed by antimicrobial susceptibility testing and biofilm production assay on Congo red agar. Multidrug- resistance, extensively drug- resistance and pandrug- resistance among isolates were considered as per international consensus.Results: Out of 353 samples, 64 (18.13%) showed positive growth in culture, confirming urinary tract infection. E. coli, 44 (68.8%) was the predominant organism followed by Klebsiella spp. 6 (14.1%). Most E. coli were sensitive to amikacin (93.2%) followed by nitrofurantoin (86.4%), and highly resistant to ampicillin (95.5%). Of 64 isolates, 23 (35.93%) were found to be multidrug- resistant strains. Biofilm was produced by 36 (56.25%) isolates.Conclusions: This study showed higher biofilm production and resistance to in-use antibiotics rendering ineffective for empirical use. Regular surveillance of resistance patterns should be done to regulate multidrug- resistant bugs and to ensure effective management of urinary tract infection in children in a tertiary care setups.Keywords: AMR; antimicrobial resistance; biofilm; urinary tract infection; UTI.

scholarly journals The Dissemination of Multidrug Resistance (MDR) and Extensively Drug Resistant (XDR) among Uropathogenic E. coli (UPEC) Isolates from Urinary Tract Infection Patients in Babylon Province, Iraq

2019 ◽  
Vol 16 (4(Suppl.)) ◽  
pp. 0986
Author(s):  
Al-Hasnawy Et al.
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Drug Resistant ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Extensively Drug Resistant

Antibiotic resistance is a problem of deep scientific concern both in hospital and community settings. Rapid detection in clinical laboratories is essential for the judicious recognition of antimicrobial resistant organisms. So, the growth of Uropathgenic Escherichia coli (UPEC) isolates with Multidrug-resistant (MDR) and Extensively Drug-resistant (XDR) profiles that thwart therapy for (UTIs) has been detected and has straight squeezed costs and extended hospital stays. This study aims to detect MDR- and XDR-UPEC isolates. Out of 42 UPEC clinical isolates were composed from UTI patients. The bacterial strains were recognized by standard laboratory protocols. Susceptibility to antibiotic was measured by the standard disk diffusion method Out of 42 Uropathogenic E. coli, 37 (88.09%) were found to be MDR while 5 isolates (11.90%) were XDR. The present study concluded high prevalence of uropathogenic Escherichia coli (UPEC) with Multidrug-resistant (MDR) isolated from urinary tract infection in Babylon province – Iraq.

scholarly journals Bacterial profile, antibiotic susceptibility pattern and associated risk factors of urinary tract infection among clinically suspected children attending at Felege-Hiwot Comprehensive and Specialized Hospital, Northwest Ethiopia. A prospective study

2020 ◽  
Author(s):  
Adugna Fenta ◽  
Mulat Dagnew ◽  
Setegn Eshetie ◽  
Teshome Belachew
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Northwest Ethiopia ◽  
Bacterial Isolates ◽  
Susceptibility Pattern ◽  
Gram Negative ◽  
Antimicrobial Susceptibility Pattern ◽  
Specialized Hospital

Abstract Background: Urinary tract infection is one of the most common bacterial infections in children. Understanding the characteristics of uropathogens and their antimicrobial susceptibility pattern in a particular setting can provide evidence for the appropriate management of cases. This study aimed to assess the bacterial profile of urinary tract infection, their antimicrobial susceptibility pattern and associated factors among clinically suspected children attending at Felege-Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia.Methods: A hospital-based cross-sectional study was conducted from February-April, 2019. A systematic sampling technique was employed. A mid-stream urine sample was inoculated on cystine lactose electrolyte deficient media and incubated for 24-48 hours. Sub-culturing was done on Mac-Conkey and blood agar. Antimicrobial susceptibility test was done on Muller-Hinton agar. A binary logistic regression model was used to see the association between dependent and independent factors. A p-value<0.05 at 95% CI was considered as statistically significant.Results: The overall prevalence of urinary tract infection was 16.7% (95% CI 12.4-21.1). Both Gram-negative and Gram-positive bacterial isolates were recovered with a rate of 44/50 (88%) and 6/50 (12%) respectively. Among Gram-negative isolates, E. coli 28/44(63.6%) was predominant while S. saprophyticus 2/6(33.3%) was prevalent among Gram-positive bacterial isolates. Overall, a high level of resistance to ampicillin, augmentin, and tetracycline was shown by Gram-negative bacteria with a rate of 44/44(100%), 39/44(88.6%), and36/44 (81.8%) respectively. About 33/50(66%) of overall multidrug resistance was observed (95% CI 52-78). About six Gram-negative bacterial isolates were extended spectrum beta-lactamase (ESBL) producers. Having a history of urinary tract infection (P-0.003, AOR 1.86-22.15) and male uncircumcision (p-0.00, AOR 5.5-65.35) were the independent variables that associate for urinary tract infections.Conclusion: In the present study, the prevalence of urinary tract infection among children was high and considerably a high proportion of multidrug resistance was observed. This result will have a significant impact on the selection of appropriate antimicrobial agents for the treatment of urinary tract infection.

scholarly journals Enhanced quantitative urine culture technique, a slight modification, in detecting under-diagnosed pediatric urinary tract infection

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Januka Thapaliya ◽  
Priyatam Khadka ◽  
Shovana Thapa ◽  
Chenu Gongal
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Slight Modification ◽  
Multidrug Resistant ◽  
Culture Technique ◽  
Simple Modification ◽  
E Coli ◽  
Conventional Culture

Abstract Objectives The pediatric urinary tract infection (UTI) often remains under-diagnosed or neglected owing to non-specific clinical presentations, patients failing to describe the actual situation and of clinical practice in diagnosis. The study was aimed to determine the etiologies of UTI in children with enhanced quantitative urine culture (EQUC) technique. Results Of enrolled 570 pediatric urine samples, the significant growth positivity was higher in EQUC 92 (16.15%) compared to standard urine culture (SUC) 73 (12.80%) technique. 20.6% of the significant isolates as detected with EQUC were missed on the SUC technique. The age group, in range 1–4 years, was more prone to the infection, where E. coli was the commonest pathogen. EQUC detected, probably all isolates, contributing UTI i.e. multidrug-resistant (MDR), extensive drug-resistant (XDR), and extended-spectrum β-lactamase (ESBL) producers, as some of them skipped on the SUC technique. Of total organisms isolated from EQUC, 46% were ESBL producer, 56.5% were MDR, and 1.4% were XDR. However, 40.5% ESBL, 44% MDR but no XDR detected on SUC. Hence a simple modification on conventional culture protocol could be a crucial modification for the detection of etiologies, contributing UTI, and hence to reduce inapt antimicrobial burden.

scholarly journals A clinical study of uropathogens causing urinary tract infection in children and adolescents in a tertiary care hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 1549
Author(s):  
R. Abisha Rezia ◽  
R. Vijendra ◽  
Anjana Gopi
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Children And Adolescents ◽  
Antimicrobial Susceptibility ◽  
Urine Samples ◽  
Diffusion Method ◽  
Care Hospital ◽  
E Coli ◽  
The Common

Background: Urinary Tract Infection (UTI) is one of the common infections in children. Incidence varies with age, race and gender. UTIs have become difficult to treat due to development of resistance among uropathogens. Regional data regarding the common uropathogens and their antimicrobial susceptibility pattern is required to guide the clinicians to start empirical therapy while treating UTIs.Aims: This study is aimed to study the profile of uropathogens causing UTI in children and adolescents, assess their antimicrobial susceptibility, the clinical course and outcome.Methods: All subjects with suspected UTI whose urine samples grew a positive culture of uropathogens were included in this prospective observational study. The study was done in the Department of Microbiology from July 2019 to December 2019. The urine samples were processed by standard methods (using 5% sheep blood agar and MacConkey agar) and antimicrobial susceptibility was performed using the Kirby-Bauer disk diffusion method. The details of the pathogens grown, and their antimicrobial sensitivity and resistance patterns were recorded, and the subjects were followed up during their course in the hospital.Results: A total of 109 urine samples from paediatric and adolescent subjects showed positive cultures (97.32%). UTI was common among toddlers (46.7%). E. coli contributed to 40.3% of the cases, followed by Enterococcus and Klebsiella pneumonaie. E. coli was resistant to amoxicillin + clavulanic acid, cephalosporins and ciprofloxacin. The organisms were sensitive to meropenem, amikacin and piperacillin + tazobactam.Conclusion: Incidence of UTI and the uropathogens causing UTI varies with age. Different uropathogens and their resistance to commonly used antimicrobials is a concern for future treatment options in UTI.

Bacterial Agents and Their Antibiotic Susceptibility in Urinary Tract Infection (UTI) of Pediatric Age Group

2019 ◽  
Vol 9 (4) ◽  
pp. 401-407
Author(s):  
Mohd Rafiq Lone*,Nisar Ahmad Ganie,Mohsin Rashid, Syed Muneeb Mohammad,Javid Ahmad,Nazir Ahmad Parray
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Antibiotic Susceptibility ◽  
Empirical Therapy ◽  
Klebsiella Species ◽  
E Coli ◽  
Tract Infections

Background: Urinary tract infections (UTIs) account for one of the common cause of hospital visits and therefore determination of the antimicrobial susceptibility patterns of uropathogens will help guide physicians to choice the best choice of antibiotics to affected patients. The aim of this study was to isolate the bacteriological agent causing the urinary tract infection and determination of their susceptibility to antibiotics. Methods: Our study was hospital based prospective study in which patients suspected of UTI were admitted and urine sample were collected using ‘urinary catheter’ method in patients less than 3 years of age, while for older children ‘mid stream clean catch’ method was used. Cultures were bacteriologically analyzed using standard microbiological procedures and antimicrobial susceptibility test was performed for the isolated pathogens.Results: 208 patients with suspected UTI were included in study, out of 208 patients, urine cultures were taken from all patients, 38 cultures (18.2%) were reported as positive. The most common pathogens isolated were Escherichia coli 27 (71%), Klebsiella Species 6 (15%), Enterococcussps 3(7.8%), Proteus sps 1(2.6%), Pseudomonas aeruginosa 1(2.6%). E. coli and Klebsiella showed the highest percentage of resistance to amoxicillin and ampicillin (100%) however, all isolates of E. coli and Klebsiella were susceptible to Nitofurantoin. Among all UTI isolates, least resistance was observed against drugs such as ceftriaxone, cefixime ciproflaxacilin and gentamicin. Conclusion: The finding of our study showed that E. Coli was the most common uropathogen and there was high resistance to routinely used drugs in clinical practice. So it high time to change the empirical therapy from conventional drugs like ampicillin and amoxicillin to drugs like nitrofurantoin or ciprofloxacilin. Keywords: Urinary tract infection, urine culture, antibiotic susceptibility.

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