A retrospective study on the microbial spectrum and antibiogram of uropathogens in children in a secondary care hospital in Rural Vellore, South India.

Abstract

Urinary tract infection (UTI) is common among children. Empiric antibiotics have to be started as early as possible or it may lead to an irreversible renal parenchymal damage and renal scarring in children. The objectives were to determine the prevalence and microbial profile of paediatric UTI and to determine the antimicrobial susceptibility pattern. This is a retrospective study which looked at urine cultures of children below 15 years that were sent during the study period. Among the total urine cultures sent only 21.2% showed significant growth of organisms. The most common organism isolated was <i>E. coli</i> (75.5%). <i>E. coli</i> was least sensitive to cefpodoxime and co-trimoxazole, whereas highly sensitive to nitrofurantoin. Of the total children who had significant growth, 46% had ESBL. The prevalence of culture-proven UTI among children was found to be 21.2%. The most common organism isolated among the study population was <i>E. coli</i> (75.5%) followed by <i>Enterococcus</i> species (19.0%) and <i>Klebsiella</i> species (14.5%). It was also found that <i>E. coli</i> was least sensitive to cefpodoxime (31.6%) and co-trimoxazole (26.3%), moderately to amoxicillin-clavulanate (52.4%), whereas highly sensitive to nitrofurantoin (82.9%). This was similar with the studies done at other secondary care hospitals, in Oman and Oddanchathram, South India. With the increasing resistance, cephalosporins should not be used in treating paediatric UTI, whereas nitrofurantoin can be started as an empiric antibiotic, which can later be changed according to the susceptibility pattern.