Antimicrobial Susceptibility Profile of Bacterial Uropathogens Isolated from Pediatric Patients at Yekatit 12 Hospital Medical College
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Date
2014-05
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Addis Ababa University
Abstract
Background: Urinary tract infection (UTI) is considered as the most common
bacterial infectious disease seen among the pediatric patients.
Objective:
This study was carried out in order to determine the antimicrobial
Susceptibility Profile of Bacterial Uropathogens Isolates from Pediatric Patients at Yekatit 12
Hospital Medical College
Materials and Methods Clean voided mid-stream urine specimens were obtained from
patients in sterile universal bottles. Urine collected from each patient was inoculated onto
CLED and blood agar plats using calibrated inoculating loop with a capacity of 0.001ml,
Inoculated plates were incubated for 24- 48 hours at 37°C at inverted position aerobically.
Bacterial isolates were characterized/ indented by gram stain and by using an array of
standard routine biochemical test. Antimicrobial susceptibility test was carried out by using
the Kirby Bauer disc diffusion.
Result: The data was analyzed by using SPSS, version 17. Descriptive statistics was
computed for most of the study variables and Frequency distribution tables were used to
describe the findings. In this study a total of 384 pediatric patients (199 males and 185
females) aged between 0 years to 15 years from whom urine sample were collected were
enrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36
(19.5%) have positive cultures while 25 (12.6%) of the 199 males had significant bacteriuria
and the largest number of study subjects were below age 3 years and the largest positive
culture was obtained from this age group, accounting 35 (57.4%.) out of 61 positive culture.
Bacterial species belonging to six genera
were isolated and identified from 61 positive
cultures and the genera were Escherichiai, Klebsiella, Staphylococcus, Proteus, Acnitobacter
and Entrococcus. and E. coli was isolated in 28 cases (28/61, 49.5 %), followed by Klebsilla
spp. in 17 cases (17/61, 27.9%), Staphylococcus spp. in 5 patients (5/61, 8.2%.) ( S. aureus in
one and coagulase negative staphylococci in 4 case), Entrococcus in 7 case (7/61, 11 5%),
Proteus spp. in 3 cases (3/61, 4.9%) ) and Acenitobacte in one case (1/61,1.6%). Of 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 pathogen in female patients
accounting 71. 4% and 64.7% respectively. percentage resistance of Klebsilla spp was much
higher when compared to E.coli. Eighty eight percent of Klebsiell spp. were resistant to
cefotaxim, ceftazidim, trimetroprimsulfamethoxazole and cefuroxime. Acentobacter spp. was
100% resistances to gentamicin, trimetroprimsulfamethoxazole , agumentin, and nalidixic
acid . But they were 100% susceptible to ciprofloxacin, cefuroxime , norfloxacine,
cefotaxim,chloramphenicol and ceftazidim . On the other hand, proteus spp. were 100%
sensitive to all drugs except nitrofurantion. Species of Entrocuccus were resistance of 71.4%
to chloramphenicol and 85.7% to both trimetroprimsulfamethoxazole and Erythromycin. S.
aurues
was
100%
susceptible
to
ciprofloxacin,
cefuroxime,
gentamicin,
trimetroprimsulfamethoxazole, chloramphenicol, Clindamycine and Ceftriaxone while
coagulase negative staphylococci were resistance to all of the above drugs except
Clindamycine and gentamicin . Multidrug resistance to two or more drugs was observed in
73.7% of bacterial isolates.
Conclusion: This study determines the antimicrobial Susceptibility Profile of Bacterial
Uropathogen Isolates from Pediatric Patients and highlighted the major
bacterial uro-
pathogens involved in UTI up to my knowledge for the first time in the country. Furthermore,
species bacterial pathogens and their frequency was consistent with the usually reported
pattern, with E. coli being the most common organism isolated followed by Klebsiella. Spp.
In this study Majority of gram negative species were susceptible to ciprofloxacin,
norfloxacine and nitrofurantion (except
proteus spp) and gram positive species were
susceptible to ciprofloxacin Clindamycine and gentamicin so this drugs can be used to treat
UTI in children however Most of bacterial isolates were multidrug resistant and it is therefore
suggested that appropriate antimicrobials should be administered to reduce the risk of multi
drug resistant organisms developing and avert ineffectiveness of antibiotics
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Keywords
Yekatit 12 Hospital Medical College