Antimicrobial Susceptibility Profile of Bacterial Uropathogens Isolated from Pediatric Patients at Yekatit 12 Hospital Medical College
Creators: name: Merga, Yamirot
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2014

description: Background: Urinary tract infection (UTI) is considered as the most common bacterial infectious disease seen among the pediatric patients. Objective: This study was carried out in order to determine the antimicrobial Susceptibility Profile of Bacterial Uropathogens Isolates from Pediatric Patients at Yekatit 12 Hospital Medical College Materials and Methods Clean voided mid-stream urine specimens were obtained from patients in sterile universal bottles. Urine collected from each patient was inoculated onto CLED and blood agar plats using calibrated inoculating loop with a capacity of 0.001ml, Inoculated plates were incubated for 24- 48 hours at 37°C at inverted position aerobically. Bacterial isolates were characterized/ indented by gram stain and by using an array of standard routine biochemical test. Antimicrobial susceptibility test was carried out by using the Kirby Bauer disc diffusion. Result: The data was analyzed by using SPSS, version 17. Descriptive statistics was computed for most of the study variables and Frequency distribution tables were used to describe the findings. In this study a total of 384 pediatric patients (199 males and 185 females) aged between 0 years to 15 years from whom urine sample were collected were enrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36 (19.5%) have positive cultures while 25 (12.6%) of the 199 males had significant bacteriuria and the largest number of study subjects were below age 3 years and the largest positive culture was obtained from this age group, accounting 35 (57.4%.) out of 61 positive culture. Bacterial species belonging to six genera were isolated and identified from 61 positive cultures and the genera were Escherichiai, Klebsiella, Staphylococcus, Proteus, Acnitobacter and Entrococcus. and E. coli was isolated in 28 cases (28/61, 49.5 %), followed by Klebsilla spp. in 17 cases (17/61, 27.9%), Staphylococcus spp. in 5 patients (5/61, 8.2%.) ( S. aureus in one and coagulase negative staphylococci in 4 case), Entrococcus in 7 case (7/61, 11 5%), Proteus spp. in 3 cases (3/61, 4.9%) ) and Acenitobacte in one case (1/61,1.6%). Of bacterial isolates E. coli was found out to be the most common pathogen followed by Klebsiella spp.. Furthermore E. coli and klebsiella spp. were the most common pathogen in female patients accounting 71. 4% and 64.7% respectively. percentage resistance of Klebsilla spp was much higher when compared to E.coli. Eighty eight percent of Klebsiell spp. were resistant to cefotaxim, ceftazidim, trimetroprimsulfamethoxazole and cefuroxime. Acentobacter spp. was 100% resistances to gentamicin, trimetroprimsulfamethoxazole , agumentin, and nalidixic acid . But they were 100% susceptible to ciprofloxacin, cefuroxime , norfloxacine, cefotaxim,chloramphenicol and ceftazidim . On the other hand, proteus spp. were 100% sensitive to all drugs except nitrofurantion. Species of Entrocuccus were resistance of 71.4% to chloramphenicol and 85.7% to both trimetroprimsulfamethoxazole and Erythromycin. S. aurues was 100% susceptible to ciprofloxacin, cefuroxime, gentamicin, trimetroprimsulfamethoxazole, chloramphenicol, Clindamycine and Ceftriaxone while coagulase negative staphylococci were resistance to all of the above drugs except Clindamycine and gentamicin . Multidrug resistance to two or more drugs was observed in 73.7% of bacterial isolates. Conclusion: This study determines the antimicrobial Susceptibility Profile of Bacterial Uropathogen Isolates from Pediatric Patients and highlighted the major bacterial uro- pathogens involved in UTI up to my knowledge for the first time in the country. Furthermore, species bacterial pathogens and their frequency was consistent with the usually reported pattern, with E. coli being the most common organism isolated followed by Klebsiella. Spp. In this study Majority of gram negative species were susceptible to ciprofloxacin, norfloxacine and nitrofurantion (except proteus spp) and gram positive species were susceptible to ciprofloxacin Clindamycine and gentamicin so this drugs can be used to treat UTI in children however Most of bacterial isolates were multidrug resistant and it is therefore suggested that appropriate antimicrobials should be administered to reduce the risk of multi drug resistant organisms developing and avert ineffectiveness of antibiotics