Clinical Microbiology: Open Access

Bacteriological Profile of Uropathogens in Pediatric Patients at Crimson Hospital Butwal Providence no.5 Nepal

Ram Khadka^* Department of Laboratory Sciences, Crimson College of Technology, Butwal, Nepal
^*Correspondence: Ram Khadka, Department of Laboratory Sciences, Crimson College of Technology, Butwal, Nepal, Email:

Received: 03-Feb-2020, Manuscript No. CMO-20-3275; Editor assigned: 06-Feb-2020, Pre QC No. CMO-20-3275(PQ); Reviewed: 20-Feb-2020, QC No. CMO-20-3275; Revised: 02-Jan-2023, Manuscript No. CMO-20-3275(R); Published: 30-Jan-2023, DOI: 10.35248/2327-5073.23.12.323

Introduction

Escherichia coli could be a sort of microorganism that usually lives in our bowel. It’s conjointly found within the gut of some animals. Most sort of E.coli are harmless and even facilitate keep your channel healthy. Whereas several folks associate E.coli with sickness you’ll be able to conjointly get respiratory illness, respiration issues, and tract infection from differing kinds of the microorganism. In fact, seventy fifth to ninety fifth of tract infections are caused by E.coli [1]. Tract infection is one in every of the foremost common medical specialty infections. It distresses the kid, considerations the oldsters, and will cause permanent excretory organ harm. It’s the foremost necessary reason for mortality and morbidity within the world moving all age teams across the life. Worldwide, concerning one hundred fitty million folks are diagnosed with UTI annually, cost accounting the world economy in more than six billion North American nation bucks. UTI could be building infections per the annual report revealed by department of health services (2059/60), morbidity of UTI in Asian country was one, 25,0584 [2,3]. Infants and toddlers cannot localize UTI symptoms, cannot submit spontaneous excrement samples, and produce other distinct characteristics compared to youngsters over twenty four months of age; thus, we’ll modify this review of UTIs into a pair of age groups: Youngsters but twenty four months archaic (whom we’ll outline as infants and toddlers during this review) and youngsters a pair of years archaic and older [4].

UTI is characterized by the presence of more than 10⁵ CFU/ml urine in the mid-stream urine sample [5]. Bacteria are common cause of UTI in children with Escherichia coli being the most commonly isolated pathogen. Susceptibility patterns of the bacteria isolates vary with geographic region and acts as a reference for guiding the empirical therapy [6]. Antibiotic are usually given empirically before the laboratory results of urine cultures are available. To ensure appropriate therapy, current knowledge of the organisms that cause UTI and their antibiotic susceptibility is mandatory [7].

Escherichia coli remained the most common causative agent of uncomplicated UTI for many years with 75%-90% causes of UTI infection. Klebsiella pneumonia accounts second highest organisms. The other gram negative pathogens causing UTI are Proteus mirabilis and Pseudomonas aeruginosa, however, Enterococci sp and Staphylococcus saprophyticus are the most frequently encountered gram positive bacteria in UTI [8,9]. To ensure appropriate therapy, current knowledge of the organisms that cause UTI and their antibiotic susceptibility testing in mandatory.

Due to rising antibiotic resistance among uropathogens, it's necessary to own native hospital based mostly information of the organisms inflicting UTI and their antibiotic sensitivity patterns. Hence the present study serves to know the prevalence of most common uropathogens Escherichia coli and their antimicrobial susceptibility pattern in pediatrics patients of Crimson hospital.

Materials and Methods

Study design, specimen collection and bacterial identification

This retrospective study was undertaken within the department of biological science in Crimson hospital, Butwal to isolate the UTI pathogens and verify their antibiotic status pattern. One hundred eighty three (183) excreta samples were collected of below 12 years age teams and each genders excluding the patients already on antibiotic medical aid consulting in biological science department of Crimson hospital every which way from the pediatricts patients sterile, wide mouthed instrumentality from the patients, the laboratory with a suspected case of UTI throughout the amount of January first to March thirteen 2017. Sample was processed consistent with the Clinical Laboratory Common Place Institute (CLSI) tips. The organism was cultivated in several culture media and confirmed by colony morphology, gram staining, hanging drop preparation and organic chemistry testing and changed Kirby Bauer’s disc diffusion technique to assess the antibiotic sensitivity pattern by the Escherichia coli isolated from the clinical specimen. Sample showing over 10⁵ CFU/ml of excreta were thought of as vital and isolated microorganism strains were more known microbiologically consistent with common place laboratory strategies [10]. Data were entered into Microsoft stand out and analyzed by mistreatment IBM SPSS twenty one.

Antimicrobial susceptibility testing

Antibiotic susceptibility testing was performed by applying modified Kirby Bauer’s disc diffusion technique as recommoneded by CLSI pointers [11]. The antibiotics used were amikacin, gentamycin, nitorfurantoin, ciprofloxacin, levofloxacin, cefpodoxime, cefixime, cefotaxime, ofloxacin, ceftriaxone (Hi-media, India). E. coli (ATCC 25922) was used as standard control strains.

Results

Out of total 183 youngsters with suspected UTI enclosed during this study, 146 (79.78%) samples showed microorganism growth within which total ninety three Escherichia coli isolated throughout culture and remaining fifty three microorganism growth showed others common uropathogens. In gift study UTI occurred a lot of in females than in males, comprising 104 (71.23%) and forty two (28.76%) severally (Tables 1-3 and Figures 1-3).

Table 1: Distribution of positive/negative growth with total gender.

Figure 1: Distribution of positive/negative growth with total gender.

Table 2: Prevalence of UTI in pediatric patients of different age and gender groups (below 12 years).

Figure 2: Prevalence of UTI in pediatric patients of different age and gender groups (below 12 years).

Table 3: Different bacteria isolated from UTI cases of pediatrics patients.

Figure 3: Different types of bacteria isolated from pediatrics patients.

The most common uropathogens was Escherichia coli isolates from 93 pediatrics patients with percentage of 63.69%. E.coli was most prevalent in pediatrics patients followed by Klebsiella oxytoca 17 (11.64%), Klebsiella pneumonia 15 (10.27%), Morganella morganni 8 (5.47%), Proteus mirabilis 5 (3.42%), Enterobacter species 4 (2.73%), Staphylococcus aureus 2 (1.36%) and Pseudomonas aeruginosa 2 (1.36%) (Table 4).

Table 4: Different antibiotic sensitivity pattern of isolated bacteria to commonly used antibiotics.

The antibiotic sensitivity test is also carried out by using MHA with different commonly used antibiotics and the sensitivity patterns of isolated bacteria from pediatricts patients urine sample has shown in Table 5. Most common uropathogen isolated in the urine culture of pediatricts patients was E.coli. Second most common uropathogens was Klebsiella oxytoca followed by Klebsiella pneumonia and Morganella morganii.

In Table 5 and Figure 4 shows the isolates were more sensitive to amikacin, followed by others antibiotics ciprofloxacin, gentamycin, cephotaxime and ceftriaxone. The most of the strains isolated in our study demonstrated resistance with nalidixic acid, cefpodoxime followed by nitrofurantoin and cotrimaxazole.

Table 5: Over all antibiotic sensitivity pattern of isolated uropathogens from pediatricts patients.

Figure 4: Antibiotic resistance pattern of isolated pathogenic microorganism.

Discussion

The study evaluated the causative agents of UTI mostly by Escherichia coli and their antimicrobial susceptibility patterns in urine sample of pediatricts patients from Crimson hospital, Butwal. Female pediatricts patients are highly affected in compared to men.

In our study the prevalence rate of isolation of uropathogens were 146 (25.04%) out of total 183 urine sample from pediatrics patients which were enrolled in our study. Similar result with prevalence of 25.7%, (21.8%) and (19.70%) [12-14]. Studies showed slightly lower in comparison to our study. Result is much higher in comparison to the findings from Rodriguez, et al. (9.8%) and less in comparison to the findings conducted by G.K Rai, et al. (37.4%) in Kathmandu, Nepal [15].

In our present study prevalence rate in female patients occurred more than in males. Out of 146 isolated obtained 104 (71.2 %) were from females while 42 (28.76%) were from males. 69.1% females compared to 30.9% male pediatricts patients with urine culture positive. The study showed that UTI is more common in females than in males due to the anatomical structure and lack of secrection produced from prostate which has bactericidal property. In this study E.coli (63.69%) was the commonest organism which is responsible for UTI in pediatricts patients. The second most common pathogenic microorganism was Klebsiella oxytoca (11.6%), followed by Klebsiella pneumonia (10.27%), Morganella morganii (5.47%), Proteus mirabilis (3.42%), Enterobacter species (2.73%), Staphylococcus aureus (1.36%) and Pseudomonas aeruginosa 2 (1.36%). This finding is most similar to the other studies where E.coli is the most frequently isolated uropathogens causing UTI [16].

The antimicrobial sensitivity and resistance pattern may differ from community to community and hospital to hospital. Our study showed the highest percentage of sensitivity with amikacin. Similar sensitivity patterns done by Raza, et al. showed the most sensitive antibiotic was found to be amikacin. In our study the most resistance drug to E.coli was found to be norfloxacin followed by co-trimoxazole. In present study the UTI caused by E.coli is not so effective by co-trimoxazole. The above mentioned result correlated with study done by baby padhmini [17].

Indiscriminate use of antibiotic without proper antibiotic susceptibility testing and easy access of antibiotics as well as poor monitoring of antibiotic sensitivity pattern during the care and management of UTI in clinical practice, the result is high percentage of resistance to commonly prescribed drugs [18,19]. An effective national and state level antibiotic policy and guidelines should be mentioned in national strict law to gain effectiveness of the antibiotics and for better treatment of pediatricts patients.

Conclusion

E.coli was found as a significant uropathogens wherever females are unit unremarkably affected then male causing UTI in pediatricts patients. Amikacin was found to be a most sensitive antibiotic and Norfloxacin as resistance antibiotic. UTI is most typical in medical specialty population, if not treated well it's going to cause important morbidity and nephritic scarring, therefore all pediatricians must treat with applicable antibiotics adequately to reduce the antibiotics resistance to chop off the increasing population of pediatricts patients from multiple medication resistance in future.

Acknowledgement

The authors would love to acknowledge, the head department of Crimson college of technology, Pokhara University. The author desires to specific high appreciation and feeling to the Crimson hospital, Manigram, Butwal, Nepal and Crimson College of technology, Devinagar, Butwal for his efforts within the preparation of this study.

Conflict of Interest

None to declare.

Financial Interest

None to declare.

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