Bacteriological Profile and Antimicrobial Resistance Patterns in Pediatric Urinary Tract Infections: A Cross-Sectional Study at Dhaka Shishu Hospital

Md. Tazul Islam

doi:10.61561/ssbj.v4i3.37

Authors

Md. Tazul Islam Dr. Md. Tazul Islam, Junior Consultant (Paediatrics), 250 Bedded General Hospital, Jamalpur, Bangladesh

DOI:

https://doi.org/10.61561/ssbj.v4i3.37

Keywords:

UTI, Antibiotic Resistance, Urinary Pathogens, Resistance

Abstract

Background: Urinary tract infections (UTIs) are a prevalent concern in pediatric healthcare, causing distress to children, raising parental concerns, and potentially leading to lasting kidney damage. The highest incidence of first-time symptomatic UTIs occurs in infants during the first year of life, with a subsequent marked decrease. Febrile infants under 2 months, presenting with unexplained fever, constitute a critical subset requiring particular attention. Knowledge of the bacteriological profile and antimicrobial resistance patterns in specific regions is crucial for guiding effective treatment strategies. Methods: A cross-sectional study was conducted at 250 Bedded General Hospital, Jamalpur, Bangladesh from Feb 2016 to Aug 2016 to assess the bacteriological profile and antibiotic resistance patterns in pediatric UTIs. A total of 147 culture-positive UTI patients were included. Bacterial isolates were identified, and colony counts for samples with ≥105 CFU/mL bacteria were considered positive. Antimicrobial susceptibility testing was performed using twelve agents, and resistance patterns were analyzed. Results: Among the 147 culture-positive UTI patients, Escherichia coli (E-coli) was the predominant isolate (70%), followed by Klebsiella spp. (13.6%), Pseudomonas (5.44%), Enterobacter spp (3.40%), Staphylococcus Aureus (3.40%), Proteus (2.72%), and Enterococcus (1.36%). Antimicrobial resistance analysis revealed varying patterns, with Cefradine (79.59%), Co-trimoxazole (SXT) (69.39%), Nalidixic acid (NA) (66.67%), and Ceftazidime (CTM) (48.98%) showing higher resistance rates. No drug exhibited 100% resistance against urinary pathogens, indicating a dynamic resistance landscape. Conclusion: This study highlights the importance of understanding local prevalence and resistance patterns in guiding empirical antibiotic selection for pediatric UTIs. The observed decrease in antimicrobial resistance underscores the need for continuous surveillance and tailored antibiotic strategies. Clinicians should base their treatment decisions on the specific epidemiological context rather than relying solely on universal or national guidelines.

References

Jadresić, L. P. "Diagnosis and management of urinary tract infections in children." Paediatrics and Child Health, 2010; 20(6): 274–278.

Adjei, C., & Opoku, C. "Urinary tract infections in African infants." International Journal of Antimicrobial Agents, 2004; 24(1): S32–S34.

Mortazavi, F., & Shahin, N. "Changing patterns in sensitivity of bacterial uropathogens to antibiotics in children." Pakistan Journal of Medical Sciences, 2009; 25(5): 801–805.

Dulczak, S., & Kirk, J. "Overview of the evaluation, diagnosis and management of urinary tract infections in infants and children." Urologic Nursing, 2005; 25:185–191.

Larcombe, J. "Urinary tract infection in children." BMJ, 1999; 319:1173–1175.

Alper, B. S., & Curry, S. H. "Urinary tract infection in children." American Family Physician, 2005; 72:2483–2488.

Abdullah, F. E., Memon, A. A., Bandukda, M. Y., & Jamil, M. "Increasing ciprofloxacin resistance of isolates from infected urines of a cross-section of patients in Karachi." BMC Research Notes, 2012; 5(1): 696–701.

Alemu, F., Moges, Y., Shiferaw, K., Tafess, K., Kassu, A., Anagaw, B., et al. "Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at University of Gondar Teaching Hospital, Northwest Ethiopia." BMC Research Notes, 2012; 5(1): 197–204.

Schmiemann, G., Gagyor, I., Hummers-Pradier, E., & Bleidorn, J. "Resistance profiles of urinary tract infections in general practice-an observational study." BMC Urology, 2012; 12(1): 33–38.

Farajnia, S., Alikhani, M. Y., Ghotaslou, R., Naghili, B., & Nakhlband, A. "Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of Iran." International Journal of Infectious Diseases, 2009; 13(2): 140–144.

Kashef, N., Djavid, G. E., & Shahbazi, S. "Antimicrobial susceptibility patterns of community-acquired uropathogens in Tehran, Iran." Journal of Infection in Developing Countries, 2010; 4(4): 202–206.

Pieore, R. K., Lazre, P. M., & Lazre, K. "Antibiotic resistance in E.coli isolated from women genitalia and trend of minimal inhibiting concentration in a semi-urban population." Current Research Journal Biological Science, 2012; 4(16): 696–701.

Hryniewicz, K., Szczypa, K., Sulikowska, A., et al. "Antibiotic Susceptibility of bacterial strains isolated from urinary tract infection in Poland." Journal of Antimicrobial Chemotherapy, 2001; 47(6): 773-780.

Farjana, R., Sadia, C., Mojibur, R., Ahmed, D., & Anwar, H. "Antimicrobial resistance pattern of gram-negative bacteria causing urinary tract infection." Stamford Journal of Pharmaceuticals Sciences, 2009; 2(1): 44-50.

Lizama, C. M., Luco, I. M., Reichhard, T. C., et al. "Urinary tract infection in a pediatrics emergency department: frequency and clinical parameters." Revista Chilena de Infectología, 2005; 22:235–241.

Lutter, S. A., Currie, M. L., Mitz, L. B., et al. "Antibiotic resistance patterns in children hospitalized for urinary tract infections." Archives of Pediatrics & Adolescent Medicine, 2005; 159:924–928.

Salah, A. A., Ahmed, S. S., Ahmed, M., Naser, A., & Ruhul, A. M. "Changing Trends in Uropathogens and their antimicrobial sensitivity pattern." Bangladesh Journal of Medical Microbiology, 2009; 3(01); 9-12.