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Isolation and antimicrobial resistance patterns of Escherichia coli causing urinary tract infections in children aged 1 to 12 years.

Biswajit Batabyal, Dr. Himanshu

Background: Urinary tract infection is a common problem worldwide. Escherichia coli are the greatest cause of primary urinary tract infections (UTI). Antimicrobial susceptibility testing provides information that allows physicians to select the most appropriate antimicrobial agents for treating a specific infection.

Objective: This study aimed to assess the current status of drug resistance among urinary Escherichia coli isolates.

Methodology and 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 Methylene Blue Agar media (EMB) and the bacterial isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by 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 and 236 (46.0%) in Female child and 220 (42.9%) of urinary pathogens are isolated. Escherichia coli isolated 50.0% from male child and 72.4% from female child. 41.9% of ESBL stains were isolates from 1 to 12 years of children (both sex). Resistance rates of Escherichia coli (1 to 12 years of children) isolates were 83.8% to Amoxicillin/ clavulanic acid, 70.5% to Cefixime, 23.5% to Fosfomycin, 26.5% to Nitrofurantoin, 63.2% to Ofloxacin, 66.1% to Ceftriaxone, 67.6% to Cefotaxime, 22.0% to Gentamicin, 89.7% to Cefpodoxime, 63.2% to Ciprofloxacin, 19.2% to Tobramycin, 80.8% to Cefprozil, 63.2% to Cotrimoxazole, 92.6% to Cefaclor, 70.5% to Doxycycline, 4.5% to Amikacin, 57.4% to Levofloxacin, 58.9% to Tetracycline and 89.8% to Cefalexin.

Conclusion: Considering the relatively increase rates of UTI and drug resistance observed in this study, continued local, regional, and national surveillance is warranted. Antibiotics should only be issued when prescribed by physicians.