Bacterial Profile and Antibiotic Susceptibility Patterns of Urinary Tract Infection among Children in Sri Lanka
DOI:
https://doi.org/10.59573/emsj.7(3).2023.34Keywords:
urinary tract infection, antibiotic susceptibility, antibiotic resistanceAbstract
Urinary tract infections (UTIs) are common among children, and bacterial resistance to commonly used antibiotics is a growing concern. In this study, we aimed to identify the bacterial profile and antibiotic susceptibility patterns of UTI among children in Sri Lanka. A total of 214 urine samples were collected from children aged 1 month to 12 years with symptoms of UTI. The samples were processed for bacterial isolation, identification, and antibiotic susceptibility testing. Escherichia coli was the most common organism isolated (70.6%), followed by Klebsiella pneumoniae (12.6%), Proteus mirabilis (7.9%), and Pseudomonas aeruginosa (5.6%). The highest resistance rates were observed against ampicillin (87.9%), followed by cotrimoxazole (71.8%) and cefotaxime (40.2%). Nitrofurantoin showed the highest susceptibility (91.6%) followed by amikacin (84.6%). Our findings suggest that E. coli is the predominant organism causing UTI among children in Sri Lanka, and there is a high prevalence of antibiotic resistance among the isolates. Nitrofurantoin and amikacin could be potential choices for empirical therapy in this setting. Continuous monitoring of antibiotic resistance patterns is necessary to guide empirical treatment and control the spread of resistant organisms.
References
Alpana, V., Vinayak, P., & Ajay, V. (2016). Mobile phone usage among youth. International Journal of Applied Research and Studies, 5(3), 1-16.
Akram, M., Shahid, M., & Khan, A. U. (2007). Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in JNMC Hospital Aligarh, India. Annals of Clinical Microbiology and Antimicrobials, 6(1), 4.
Al-Orifi, F., McGillivray, D., Tange, S., et al. (2011). Urinary tract infections in children: diagnosis, treatment, and long-term management. Paediatr Drugs, 13(1), 1-14.
Avanthi, R. & Jayatissa, P. (2017). Review on Next Generation Sequencing. Indian Journal of Biology, 4(1), 14–18.
Clinical and Laboratory Standards Institute (CLSI). (2015). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fifth Informational Supplement. CLSI document M100-S25. Wayne, PA: CLSI.
European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for the interpretation of MICs and zone diameters. Version 9.0. Available online: http://www.eucast.org.
Flores-Mireles, A. L., Walker, J. N., Caparon, M., & Hultgren, S. J. (2015). Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology, 13(5), 269-284.
Gupta, K., Hooton, T. M., Naber, K. G., Wullt, B., Colgan, R., Miller, L. G., ... & Soper, D. E. (2011). International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical Infectious Diseases, 52(5), e103-e120.
Gupta, K., Hooton, T. M., & Stamm, W. E. (2011). Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Annals of Internal Medicine, 155(4), 243-244. doi: 10.7326/0003-4819-155-4-201108160-00011
Kahlmeter, G. & Menday, P. (2003). Cross-resistance and associated resistance in 2478 Gram-negative bacteria to antimicrobial agents. The JANUS Project. Ann Clin Microbiol Antimicrob., 2(1).
Karlowsky, J. A., Kelly, L. J., Thornsberry, C., Jones, M. E., & Sahm, D. F. (2002). Trends in antimicrobial resistance among urinary tract infection isolates of Escherichia coli from female outpatients in the United States. Antimicrobial Agents and Chemotherapy, 46(8), 2540-2545.
Lexicomp Online. (2023). Nitrofurantoin: Drug information. Wolters Kluwer Clinical Drug Information, Inc. Accessed February 15, 2023.
Manoharan, A., Chatterjee, S., Mathai, D., et al. (2003). Antibiotic susceptibility of gram-negative urinary pathogens in rural India: a multi-centre study. Int J Antimicrob Agents, 22(Suppl 2).
Menezes, G. A., Harish, B. N., Sujatha, S., et al. (2008). A clinicomicrobiological study of urinary tract infection in South India. Indian J Med Microbiol., 26(1), 26-31.
Nicolle, L. E. (2012). Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis. Urologic Clinics of North America, 39(1), 1-16. doi: 10.1016/j.ucl.2011.10.003
Oliphant, C. M. & Green, G. M. (2002). Quinolones: a comprehensive review. Am Fam Physician., 65(3), 455-64.
Schentag, J. J., Hyatt, J. M., Carr, J. R., et al. (1999). Genesis of antibiotic-dependent organisms: a pharmacodynamic explanation for the emergence of resistance in pathogenic bacteria. Am J Health Syst Pharm, 56(Suppl 4), S14-7.
Shaikh, N., Morone, N. E., Bost, J. E., & Farrell, M. H. (2008). Prevalence of urinary tract infection in childhood: a meta-analysis. The Pediatric infectious disease journal, 27(4), 302-308.
Thomson, K. S. (2010). Extended-spectrum-beta-lactamase, AmpC, and carbapenemase issues. J Clin Microbiol., 48(4), 1019-25.
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