Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh

Md. Atiqul Islam; Sheuly Begum; Salina Shaheen Parul; A. K. M. Tajuddin Bhuyian; Md. Tazul Islam; Md. Kariul Islam

doi:doi:10.11648/j.ajp.20190504.14

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Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh

Md. Atiqul Islam, Sheuly Begum, Salina Shaheen Parul, A. K. M. Tajuddin Bhuyian, Md. Tazul Islam, Md. Kariul Islam

Published in American Journal of Pediatrics (Volume 5, Issue 4)

Received: 19 June 2019 Accepted: 31 July 2019 Published: 18 September 2019

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Abstract

Urinary tract infection (UTI) is one of the most common pediatric infections. It distresses the child, concerns the parents, and may cause permanent kidney damage. Occurrences of a first-time symptomatic UTI are highest in boys and girls during the first year of life and markedly decrease after that. Febrile infants younger than 2 months constitute an important subset of children who may present with fever without a localizing source. For resistance knowledge of etiology pathogens of UTIs and their antimicrobial resistance patterns in specific geographical location may help clinicians in choosing the appropriate antimicrobial. Our aim was to assess bacteriological profile and antibiotic resistance pattern in pediatric UTI. A cross sectional study was conducted at Dhaka Shishu Hospital during the period from Feb 2016 to Aug 2016. A total of 147 culture positive UTI patient were considered for analysis. Colony counts for these samples were identified, and the profile of antibiotic resistance was identified. Here, samples with a colony count of ≥105 CFU/mL bacteria were considered positive. A total 147 culture positive UTI patients were enrolled. Here, Escherichia coli (E-coli) was found as the most prevalent isolates 103 (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%. Twelve (12) antimicrobial agents were used for antimicrobial susceptibility testing. The most resistant drugs we found were Colistin (CL) (94.55%), followed by Cefradine (79.59%), Co-trimoxazole (SXT) (69.39%), Nalidixic acid (NA) (66.67%) and Ceftazidime (CTM) (48.98%). None of the drug found was 100% resistance against urinary pathogens. Antimicrobial drug resistance is decreasing among urinary pathogens. We suggest that, empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organism and their antibiotic resistance in a specific area rather than on universal or even national guidelines.

Published in	American Journal of Pediatrics (Volume 5, Issue 4)
DOI	10.11648/j.ajp.20190504.14
Page(s)	191-195
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

UTI, Antibiotic Resistance, Urinary Pathogens

References

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[2]	Adjei and COpoku, “Urinary tract infections in African infants,” International Journal of Antimicrobial Agents, 2004; 24 (1): S32–S34.
[3]	F Mortazavi and NShahin, “Changing patterns in sensitivity of bacterial uropathogens to antibiotics in children,” Pakistan Journal of Medical Sciences, 2009; 25 (5): 801–805.
[4]	Dulczak S, Kirk J Overview of the evaluation, diagnosis and management of urinary tract infections in infants and children. UrolNurs 2005; 25: 185–191.
[5]	Larcombe J. Urinary tract infection in children. BMJ 1999; 319: 1173–1175.
[6]	Alper BS, Curry SH. Urinary tract infection in children. Am Famil Phys 2005; 72: 2483–2488.
[7]	F. E. Abdullah, AA, Memon, MY, Bandukda, and M Jamil, “Increasing ciprofloxacin resistance of isolates from infected urines of a cross-section of patients in Karachi,” BMC Research Notes, 2012; 5 (1): 696–701.
[8]	Alemu, F Moges, Y Shiferaw, K Tafess, AKassu, B. Anagaw, 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.
[9]	G. Schmiemann, I Gagyor, E Hummers-Pradier, and J. Bleidorn, “Resistance profiles of urinary tract infections in general practice-an observational study,” BMC Urology, 2012; 12 (1): 33-38.
[10]	S. Farajnia, MY Alikhani, R Ghotaslou, B Naghili, and ANakhlband, “Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of Iran,” International Journal of Infectious Diseases, 2009; 13 (2): 140–144.
[11]	N. Kashef, GE Djavid, and SShahbazi, “Antimicrobial susceptibility patterns of community-acquired uropathogens in Tehran, Iran,” Journal of Infection in Developing Countries, 2010; 4 (4): 202–206.
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[13]	Clinical Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; Nineteenth Informational Supplement (M100-S19). Wayne, PA: CLSI; 2009.
[14]	Nabi SN, Haider KMTS, Rahimgir M, Uddin MN, Shapla NR et al; “Current trends of urinary pathogens & their antimicrobial susceptibility pattern in a tertiary care hospital,” JAFMC Bangladesh. (December) 2014; 10 (2).
[15]	Hryniewicz K, Szczypa K, SulikowskaA et al. Antibiotic Susceptibility of bacterial stains isolated from urinary tract infection in Polland. J. Antimicrobchemother 2001; 47 (6): 773-80.
[16]	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 sci 2009; 2 (1): 44-50.
[17]	Lizama CM, Luco IM, Reichhard TC, et al. Urinary tract infection in a pediatrics emergency department: frequency and clinical parameters. Rev ChilenaInfectol 2005; 22: 235–241.
[18]	Lutter SA, Currie ML, Mitz LB, et al. Antibiotic resistance patterns in children hospitalized for urinary tract infections. Arch PediatrAdolesc Med 2005; 159: 924-928.
[19]	Salah AA, Ahmed SS, Ahmed M, Naser A, Ruhul A M. Changing Trends in Uropathogens and their antimicrobial sensitivity pattern. Bangladesh J Med Microbial 2009; 03 (01); 9-12.
[20]	Tantry BA, Rahiman S. Antibacterial resistance and trend of urinary tract pathogens in commonly used antibiotics in khasmir Valley; West Indian med J 2012; 61 (7): 43-44.

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Md. Atiqul Islam, Sheuly Begum, Salina Shaheen Parul, A. K. M. Tajuddin Bhuyian, Md. Tazul Islam, et al. (2019). Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh. American Journal of Pediatrics, 5(4), 191-195. https://doi.org/10.11648/j.ajp.20190504.14

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Md. Atiqul Islam; Sheuly Begum; Salina Shaheen Parul; A. K. M. Tajuddin Bhuyian; Md. Tazul Islam, et al. Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh. Am. J. Pediatr. 2019, 5(4), 191-195. doi: 10.11648/j.ajp.20190504.14

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AMA Style

Md. Atiqul Islam, Sheuly Begum, Salina Shaheen Parul, A. K. M. Tajuddin Bhuyian, Md. Tazul Islam, et al. Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh. Am J Pediatr. 2019;5(4):191-195. doi: 10.11648/j.ajp.20190504.14

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@article{10.11648/j.ajp.20190504.14,
  author = {Md. Atiqul Islam and Sheuly Begum and Salina Shaheen Parul and A. K. M. Tajuddin Bhuyian and Md. Tazul Islam and Md. Kariul Islam},
  title = {Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh},
  journal = {American Journal of Pediatrics},
  volume = {5},
  number = {4},
  pages = {191-195},
  doi = {10.11648/j.ajp.20190504.14},
  url = {https://doi.org/10.11648/j.ajp.20190504.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190504.14},
  abstract = {Urinary tract infection (UTI) is one of the most common pediatric infections. It distresses the child, concerns the parents, and may cause permanent kidney damage. Occurrences of a first-time symptomatic UTI are highest in boys and girls during the first year of life and markedly decrease after that. Febrile infants younger than 2 months constitute an important subset of children who may present with fever without a localizing source. For resistance knowledge of etiology pathogens of UTIs and their antimicrobial resistance patterns in specific geographical location may help clinicians in choosing the appropriate antimicrobial. Our aim was to assess bacteriological profile and antibiotic resistance pattern in pediatric UTI. A cross sectional study was conducted at Dhaka Shishu Hospital during the period from Feb 2016 to Aug 2016. A total of 147 culture positive UTI patient were considered for analysis. Colony counts for these samples were identified, and the profile of antibiotic resistance was identified. Here, samples with a colony count of ≥105 CFU/mL bacteria were considered positive. A total 147 culture positive UTI patients were enrolled. Here, Escherichia coli (E-coli) was found as the most prevalent isolates 103 (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%. Twelve (12) antimicrobial agents were used for antimicrobial susceptibility testing. The most resistant drugs we found were Colistin (CL) (94.55%), followed by Cefradine (79.59%), Co-trimoxazole (SXT) (69.39%), Nalidixic acid (NA) (66.67%) and Ceftazidime (CTM) (48.98%). None of the drug found was 100% resistance against urinary pathogens. Antimicrobial drug resistance is decreasing among urinary pathogens. We suggest that, empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organism and their antibiotic resistance in a specific area rather than on universal or even national guidelines.},
 year = {2019}
}

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TY - JOUR
T1 - Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh
AU - Md. Atiqul Islam
AU - Sheuly Begum
AU - Salina Shaheen Parul
AU - A. K. M. Tajuddin Bhuyian
AU - Md. Tazul Islam
AU - Md. Kariul Islam
Y1 - 2019/09/18
PY - 2019
N1 - https://doi.org/10.11648/j.ajp.20190504.14
DO - 10.11648/j.ajp.20190504.14
T2 - American Journal of Pediatrics
JF - American Journal of Pediatrics
JO - American Journal of Pediatrics
SP - 191
EP - 195
PB - Science Publishing Group
SN - 2472-0909
UR - https://doi.org/10.11648/j.ajp.20190504.14
AB - Urinary tract infection (UTI) is one of the most common pediatric infections. It distresses the child, concerns the parents, and may cause permanent kidney damage. Occurrences of a first-time symptomatic UTI are highest in boys and girls during the first year of life and markedly decrease after that. Febrile infants younger than 2 months constitute an important subset of children who may present with fever without a localizing source. For resistance knowledge of etiology pathogens of UTIs and their antimicrobial resistance patterns in specific geographical location may help clinicians in choosing the appropriate antimicrobial. Our aim was to assess bacteriological profile and antibiotic resistance pattern in pediatric UTI. A cross sectional study was conducted at Dhaka Shishu Hospital during the period from Feb 2016 to Aug 2016. A total of 147 culture positive UTI patient were considered for analysis. Colony counts for these samples were identified, and the profile of antibiotic resistance was identified. Here, samples with a colony count of ≥105 CFU/mL bacteria were considered positive. A total 147 culture positive UTI patients were enrolled. Here, Escherichia coli (E-coli) was found as the most prevalent isolates 103 (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%. Twelve (12) antimicrobial agents were used for antimicrobial susceptibility testing. The most resistant drugs we found were Colistin (CL) (94.55%), followed by Cefradine (79.59%), Co-trimoxazole (SXT) (69.39%), Nalidixic acid (NA) (66.67%) and Ceftazidime (CTM) (48.98%). None of the drug found was 100% resistance against urinary pathogens. Antimicrobial drug resistance is decreasing among urinary pathogens. We suggest that, empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organism and their antibiotic resistance in a specific area rather than on universal or even national guidelines.
VL - 5
IS - 4
ER -

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Author Information

Md. Atiqul Islam

Department of Paediatric Infectious Diseases and Community Paediatrics, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
Sheuly Begum

Department of Gynaeocology &Obstetrics, Enam Medical College, Savar, Dhaka, Bangladesh
Salina Shaheen Parul

Bio-chemistry Department, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh
A. K. M. Tajuddin Bhuyian

Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
Md. Tazul Islam

250 Bedded General Hospital, Jamalpur, Bangladesh
Md. Kariul Islam

International Online Journal Hub (IOJH), Dhaka, Bangladesh

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APA Style

Md. Atiqul Islam, Sheuly Begum, Salina Shaheen Parul, A. K. M. Tajuddin Bhuyian, Md. Tazul Islam, et al. (2019). Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh. American Journal of Pediatrics, 5(4), 191-195. https://doi.org/10.11648/j.ajp.20190504.14

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ACS Style

Md. Atiqul Islam; Sheuly Begum; Salina Shaheen Parul; A. K. M. Tajuddin Bhuyian; Md. Tazul Islam, et al. Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh. Am. J. Pediatr. 2019, 5(4), 191-195. doi: 10.11648/j.ajp.20190504.14

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AMA Style

Md. Atiqul Islam, Sheuly Begum, Salina Shaheen Parul, A. K. M. Tajuddin Bhuyian, Md. Tazul Islam, et al. Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh. Am J Pediatr. 2019;5(4):191-195. doi: 10.11648/j.ajp.20190504.14

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@article{10.11648/j.ajp.20190504.14,
  author = {Md. Atiqul Islam and Sheuly Begum and Salina Shaheen Parul and A. K. M. Tajuddin Bhuyian and Md. Tazul Islam and Md. Kariul Islam},
  title = {Antibiotic Resistance Pattern in Children with UTI: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh},
  journal = {American Journal of Pediatrics},
  volume = {5},
  number = {4},
  pages = {191-195},
  doi = {10.11648/j.ajp.20190504.14},
  url = {https://doi.org/10.11648/j.ajp.20190504.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190504.14},
  abstract = {Urinary tract infection (UTI) is one of the most common pediatric infections. It distresses the child, concerns the parents, and may cause permanent kidney damage. Occurrences of a first-time symptomatic UTI are highest in boys and girls during the first year of life and markedly decrease after that. Febrile infants younger than 2 months constitute an important subset of children who may present with fever without a localizing source. For resistance knowledge of etiology pathogens of UTIs and their antimicrobial resistance patterns in specific geographical location may help clinicians in choosing the appropriate antimicrobial. Our aim was to assess bacteriological profile and antibiotic resistance pattern in pediatric UTI. A cross sectional study was conducted at Dhaka Shishu Hospital during the period from Feb 2016 to Aug 2016. A total of 147 culture positive UTI patient were considered for analysis. Colony counts for these samples were identified, and the profile of antibiotic resistance was identified. Here, samples with a colony count of ≥105 CFU/mL bacteria were considered positive. A total 147 culture positive UTI patients were enrolled. Here, Escherichia coli (E-coli) was found as the most prevalent isolates 103 (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%. Twelve (12) antimicrobial agents were used for antimicrobial susceptibility testing. The most resistant drugs we found were Colistin (CL) (94.55%), followed by Cefradine (79.59%), Co-trimoxazole (SXT) (69.39%), Nalidixic acid (NA) (66.67%) and Ceftazidime (CTM) (48.98%). None of the drug found was 100% resistance against urinary pathogens. Antimicrobial drug resistance is decreasing among urinary pathogens. We suggest that, empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organism and their antibiotic resistance in a specific area rather than on universal or even national guidelines.},
 year = {2019}
}

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