ISSN: 2576-7771
Commonly Use of Oral Antibiotics Resistance in Children Aged 1 to 12 years with UTI’s a Increasing Problems
Background: Urinary tract infections (UTIs) are counted among the most common infections in children. Most commonly, members of Enterobacteriacea, particularly urinary pathogenic strains of E. coli and Enterobacter aerogenes are the primary causative organisms of UTIs in different parts of the world. . In spite of the availability and use of the antimicrobial drugs, UTIs caused by bacteria have been showing increasing trends. Antibiotics are a mainstay in the treatment of bacterial infections, though their use is a primary risk factor for the development of antibiotic resistance. Antibiotic resistance is a growing problem in pediatric urology as demonstrated by increased urinary pathogen resistance. The extensive and inappropriate use of antimicrobial agents has invariably resulted in the development of antibiotic resistance which, in recent years, has become a major problem worldwide. Increasing antibiotic resistance among urinary pathogens to commonly prescribed drugs has become a global reality today. Complex pediatric patients with histories of hospitalizations, prior antibiotic exposure, and recurrent UTIs are also at high risk for acquiring UTIs due to extended spectrum beta-lactamase [ESBL] producing organisms. Data regarding the impact of in vitro antibiotic susceptibility testing interpretation on UTI treatment outcomes is lacking. The resistance of bacteria causing urinary tract infection (UTI) to commonly prescribed antibiotics is increasing both in developing as well as in developed countries. Resistance has emerged even to more potent antimicrobial agents. Objective: The present study was undertaken to report the commonly use of current antibiotic resistance pattern among common bacterial urinary pathogens isolated.
Methodology & Results: A total of 512 urine samples were collected from out patients of age between 1 to 12 years of both sex of children at Serum Analysis Center Pvt. Ltd. [Referral Laboratory]; Howrah; West Bengal; India between December 2016 to November 2017. The urine samples were cultured on HiCrome UTI Agra media and Eosin MethyleneBlue Agar media [EMB] and the bacterial isolates were identified by gram staining and conventional biochemical methods. The bacterial isolates recovered of commonly use of oral antibiotics were tested against Amoxicillin/clavulanate, Cefixime, Cefpodoxime, Cefprozil, Cephalexin and Co-trimoxazole (Trimethoprim/sulfamethoxazole) using Kirby Bauer disk diffusion method according to the current National Committee for Clinical Laboratory Standards (NCCLS) guidelines. Among the 512 urine samples examined [1 to 12 years of children], included 276 (54.0%) in Male child & 236 (46.0%) in Female child and 220 (42.9%) of urinary pathogens are isolated. The bacteria were isolates 104 (37.7%) of male child and 116 (49.2%) of female child. In patient of male child, 50% of E. coli, 34.6% of Klebsiella pneumoniae, 15.4% of others gram negative bacilli and 52.0% Extended- spectrum Beta lactamase [ESBL] stains were isolates. In patient of female child, 72.4% of E. coli, 20.7% of Klebsiella pneumoniae , 6.9% of others gram negative bacilli and 58.7% Extended- Spectrum Beta lactamase [ESBL] stains were isolates. Resistance rates of E. coli [1 to 12 years of children] isolates were 83.8% to Amoxicillin/clavulanate, 70.5% to Cefixime, 89.7% to Cefpodoxime, 80.8% to Cefprozil, 89.8% of Cefalexin and 63.2% to Co-trimoxazole. Resistance rates of Klebsiella pneumoniae [1 to 12 years of children] isolates were 66.7% to Amoxicillin/clavulanate, 43.3% to Cefixime, 90% to Cefpodoxime, 76.6% to Cefprozil, 80% to Cefalexin and 50% to Co-trimoxazole. Resistance rate of Others gram negative bacilli [1 to 12 years of children] isolates were 75% to Amoxicillin/clavulanate, 33.4% to Cefixime, 91.6% to Cefpodoxime, 91.6% to Cefprozil, 91.6% to Cefalexin and 41.7 % to Co-trimoxazole.
Conclusion: Increasing antibiotic resistance trends indicate that it is imperative to rationalize the use of antimicrobials in the community and also use these conservatively. It is concluded that the clinical isolates have started developing resistance against commonly use antibiotics due to its irrational and inappropriate use. Continuous surveillance is crucial to monitor the antimicrobial resistance of pathogens. Finally, we suggest that empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organisms and antibiotic sensitivities rather than on universal guidelines.
Keywords:
Urinary Tract Infections; Antibiotic Resistance; Pediatrics; Oral Antibiogram
