Prevalence and antibiotic susceptibility of urinary tract infections in febrile children below 10 years attending Mulago hospital

Abstract

Urinary tract infections (UTIs) are one of the most common infections in the pediatrics population. This study was performed to determine the prevalence of urinary tract infections amongst febrile children below 10 years attending Mulago National Referral Hospital, and the susceptibility patterns of the isolated uropathogens to common antibiotics. A cross-sectional study of febrile pediatric patients below 10 years from various ward of Mulago National Referral Hospital was conducted between January and May 2019. 160 participants met the inclusion criteria and were enrolled into the study. Patient’s information was collected through checking the medical files and interviews with the caretakers/parents. Mid-stream urine samples were also collected. The urine samples were cultured onto Blood Agar and Cystine Lactose Electrolyte Deficient (CLED) simultaneously. Growth was considered significant when a pure isolate had ≥ 105CFU/mL. Susceptibility to 8 antibiotics was set using the modified Kirby-Bauer disc diffusion technique. Of the 160 participants, 83(51.9%) were girls while 77(48.1%) were boys. 44(27.5%) of participants where 3 years and below, 52(32.5%) where above 3 years to 6 years, 64(40%) where between 6 and 10 years. Of the 160 urine samples, 29(18.1%) had significant bacterial growth. The frequency of UTIs was significantly higher in girls 20(69.0%) than boys 9(31.0%). Escherichia coli was the most predominant organism with 41.4%, followed by Klebsiella pneumoniae at 20.7%, Staphylococcus aureus at 13.8%, Pseudomonas aeruginosa at 10.3%, Citrobacter freundii at 6.9%, proteus mirabilis at 3.4% and Enterobacter spp. at 3.4%. Overall susceptibility tests exhibited a very high Antibiotic resistance of uropathogens to ampicillin (96.6%), cotrimoxazole (82.8%) and nalidixic-acid. Nitrofurantoin and imipenem showed the lowest resistances of 34.5% and 31.0% respectively. 24(82.8%) isolates were multidrug resistant. Bacteriuria is a common condition amongst febrile children attending Mulago hospital, with Enterobacteriaceae being the most predominant uropathogens. Uropathogens were highly sensitive to nitrofurantoin and imipenem but with significant resistance to ampicillin and cotrimoxazole