Microorganisms causing urinary tract infection (UTI) & their susceptibility among children aged 0 to 5 years at French Medical Institute for Children, Kabul Afghanistan

Date of Award

1-2016

Document Type

Thesis

Degree Name

Diploma in Paediatric Medicine

First Supervisor/Advisor

Abdul Wahid Sabet

Second Supervisor/Advisor

Rahima Stanikzai

Department

French Medical Institute for Children

Abstract

Introduction: Urinary tract infections (UTI) are the common medical problem affecting children that lead to frequent clinic visit and hospitalization. Undiagnosed, untreated UTI may lead to renal scoring, hypertension and end stage renal disease, early detection and treatment of UTI in children must be prompt.
Objective: To isolate the causative organisms causing UTI among children of 0-5 years of age and to determine the antibiotic susceptibility of the isolated microorganisms.
Methodology: Clinical data and outcome were prospectively analyzed for 140 patients with confirmed diagnosis of urinary tract infection (UTI) based on urine culture and sensitivity report. The data collected from June to August 2015 and the study done on Afghan children who were aged between 0 to 5 years included data of outpatients and admitted patients came to clinic at FMIC Kabul Afghanistan.
Results: A total of one hundred and forty (n=140) children aged 0 to 5 years with UTI were included in this study. Out of 140 patients, 94 (67.14%) were female, while 46 (32.82%) were male. Escherichia coli (E.coli) were the most common isolated uropathogen. out of 89 cases of E.coi; 62.14 % cases showed their highest sensitivity to Augmentin, Aminoglycosides and third generation cephalosporin while, 37.86% exhibited their extended spectrum beta lactamase (ESBL) properties which, showed their highest sensitivity to Amikacine, Fosfomycine and Imipenem. The second common uropathogen was Klebsiella pneumonia 7.86% followed by Serratia odorifera 7.14%, Enterococcus 5.71%, Proteus 6.46% and others 9.29%.
Conclusion: Culture conformation and proper treatment of the organisms causing UTI in children is the key to success. E.coli is the leading uropathogen which showed its highest 7 sensitivity to Augmentin, Amino glycosides and third generation cephalosporin which are still the most suitable agents for empiric therapy in pediatric UTI. At the hospital setting, E-coli and Klebsiella pneumonia were the organisms that exhibited extended spectrum Beta- lactamase (ESBL) properties which revealed that, resistance to commonly used antibiotics is on the rise. The treatment recommendations of community acquired uropathogen should be based on individual urine culture conformation and sensitivity result.

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