Epidemiology of urinary tract infection and antimicrobial resistance in a pediatric hospital in Nepal

BMC Infect Dis. 2019 May 14;19(1):420. doi: 10.1186/s12879-019-3997-0.

Abstract

Background: Urinary tract infection is an infection affecting infants and children. The aim of this study was to determine the etiology of urinary tract infection along with their antimicrobial resistance.

Methods: This cross-sectional study was conducted from June 2015 to January 2016 at Siddhi Memorial Hospital, Bhaktapur, Nepal. Urine samples were first cultured on cystine lactose electrolyte deficient agar and blood agar by semi-quantitative technique, and then incubated aerobically for 18-24 h at 37 °C. The identified bacterial isolates were tested for antimicrobial susceptibility by Kirby Bauer disc diffusion technique.

Results: Of 1599 urine samples, 12.3% samples showed significant bacterial growth. E. coli (58.7%) was the most common pathogen, followed by Klebsiella pneumoniae (22.5%). Most of the isolates were resistant to ampicillin and co-trimoxazole, while least were resistant to amikacin and nitrofurantoin. Higher multi-drug resistance (61.9%) was observed among isolates.

Conclusions: E. coli and Klebsiella spp. were predominant cause of pediatric urinary tract infection in children. Higher susceptibility observed against aminoglycosides and nitrofurans make these drugs suitable in emergency.

Keywords: Antimicrobial resistance; E. coli; Klebsiella spp.; Nepal; Urinary tract infection.

MeSH terms

  • Adolescent
  • Ampicillin / pharmacology
  • Ampicillin / therapeutic use
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial* / drug effects
  • Escherichia coli / drug effects
  • Escherichia coli / isolation & purification
  • Female
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Infant, Newborn
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Microbial Sensitivity Tests
  • Nepal / epidemiology
  • Trimethoprim, Sulfamethoxazole Drug Combination / pharmacology
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology

Substances

  • Anti-Bacterial Agents
  • Ampicillin
  • Trimethoprim, Sulfamethoxazole Drug Combination