Assesment of Antimicrobial Resistance Modes in Children with Pyelonephritis

Subject Areas : Journal of Chemical Health Risks

Hulal Saleh Sahib ¹ , Falah Mahdi Al-Khafaji ² , Ahmed Ali Obaid ³

1 - Department of conservative therapy, F.I.B.M.S pediatrics, Assistant Professor, College of dentistry- Al-Qadisiyah University, Iraq
2 - Department of Urology, Assistant Professor, College of medicine, Al-Qadisiyah University, Iraq
3 - Department of Urology, Assistant Professor, College of medicine, Al-Qadisiyah University, Iraq

Received: 2021-04-21 Accepted : 2022-03-05 Published : 2022-09-01

Keywords: Iraq, Children, antimicrobial resistance, Pyelonephritis, Al- Diwaniya city,

Abstract :

Pyelonephritis is a common pediatric infection with high risk of renal injury in children less than 5 years. Prompt diagnosis and treatment is mandatory to minimize the risk of renal scarring. To investigate the causative pathogen of pediatric pyelonephritis and to assess antibiotic resistance among these patients. The study conducted from the 1st of April 2019 to the 30th of December 2019 at Al-Diwaniya maternity and children teaching hospital and at outpatient clinic. Total number of patients involved were 130 children. We classified them in to two groups. Group 1(3 months -12 months) while Group 2 were (1-5 years old). Total number of patients involved in this study were 130 patients. 54 of them were (3-12 months) termed as group 1 and 76 of them (1-5 years) were group 2. From 130 urine samples, we get 186 bacterial isolate, majority was with one bacterial isolate (67.1%), multiple bacterial isolate also seen but in less number (32.9%). Regarding the causative bacterial pathogen. E. coli was the commonest microorganism isolated (73.07%), then Proteus mirabilis (16.92%), enterococcus (6.15%) and staphylococcus aureus (3.84%). On evaluating antibiotic sensitivity, we found that Imipenem , Nalidxic acid , Nitrofurantoin and Ciprofloxacin are highly sensitive antibiotics in vitro. Gentamycin show less sensitivity than amikacin. Cephalosporin, Penicillin and Trimethoprim-sulfamethoxazole show no valuable sensitivity (very high resistance).

References:

1. Chang S.L., Shortliffe L.D., 2006. Pediatric urinary tract infections, Pediatr. Clin. 53(3), 379-400.


2. Peng N.J., Hu C., Wu C.S., Tsay D.G., Chiou Y.H., 2009. Incidence and relationship of vesicoureteral reflux and acute pyelonephritis in children with first urinary tract infection. Ann Nucl Med Sci. 22, 67-74.


3. Elder J.S., Peters C.A., Arant B.S., Ewalt D.H., Hawtrey C.E., Hurwitz R.S., Parrott T.S., Snyder H.M., Weiss R.A., Woolf S.H., Hasselblad V., 1997. Pediatric Vesicoureteral Reflux Guidelines Panel summary report on the management of primary vesicoureteral reflux in children.  J Urol. 157(5), 1846-1851.


4. Tullus K., 2011. Difficulties in diagnosing urinary tract infections in small children. Pediatr. Nephrol. 26(11), 1923-1926.


5. Peters C.A., Skoog S.J., Arant B.S., Copp H.L., Elder J.S., Hudson R.G., Khoury A.E., Lorenzo A.J., Pohl H.G., Shapiro E., Snodgrass W.T., 2010. Summary of the AUA guideline on management of primary vesicoureteral reflux in children. J Urol. 184(3), 1134-1144.


6. Kayaş L., Yolbaş İ., Ece A., Kayaş Y., Kocamaz H., 2011. Causative agents and antibiotic susceptibilities in children with urinary tract infection. J Microbiol Infect Dis. 1(1), 17-21.


7. Shaikh N., Morone N.E., Bost J.E., Farrell M.H., 2008. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J. 27(4), 302-308.


8. Wiswell T.E., Roscelli J.D., 1986. Corroborative evidence for the decreased incidence of urinary tract infection in circumcised male infants. Pediatr. 78(1), 96-9.


9. Halimeh L., Al-Amouri M., 2014. Antibiotic Sensitivity of Uropathogens in Acute Pyelonephritis Children. Int J Pharm Sci Rev Res. 27(1), 234-237.


10. Peco-Antić A., Paripović D., Buljugić S., Kruscić D., Spasojević B., Cvetković M., Kostić M., Laban-Nestorović S., Milosevski-Lomić G., 2012. Antibiotic resistance of uropathogens in newborns and young children with acute pyelonephritis. Srp Arh Celok Lek. 140 (3-4), 179-183.


11. Aghamahdi F., Hashemian H., Shafiei M., Akbarian Z., Nejad M.R., Karkan M.F., 2013. Etiologies and antibiotic resistance patterns in Infants with urinary tract infections hospitalized in children medical center, Rasht, Iran. Iran J Neonatol. 4(2), 21-25.


12. Ghadage D.P., Nale S.S., Kamble D.S., Muley V.A., Wankhade A.B., Mali R.J., Bhore A.V., 2014. Study of aetiology and anti-biogram of uropathogens in children-a retrospective analysis. J Clin Diagnos Res. 8(1), 20-22.


13. AL-Geborry G.M., 2010. Etiology of bacterial Pathogens Caused urinary tract infections in Children of Al-Nasseria City. J Techniques. 23(3), 72-80.


14. AL-Harthi A.A., Al-fifi S.H., 2008. Antibiotic resistance pattern and empirical therapy for urinary tract infections in children. Saudi Med J. 29(6), 854-858.


15. Khamees S.S., 2012. Urinary tract infection: causative agents, the relation between bacteriuria and pyuria. World Applied Sci J. 20(5), 683-6.


16. Ipek I.Ö., Bozaykut A., Arman D.C., Sezer R.G., 2011. Antimicrobial resistance patterns of uropathogens among children in Istanbul, Turkey, Southeast Asian. J Trop Med Public Health. 42(2), 355-362.


17. Mohammad-Jafari H., Saffar M.J., Nemate I., Khalilian H.S.A.R., 2012. Increasing antibiotic resistance among uropathogens isolated during years 2006-2009: impact on the empirical management. Int Braz J Urol. 38(1), 25-32.


18. Afsharpaiman S., Bairaghdar F., Torkaman M., Kavehmanesh Z., Amirsalari S., Moradi M., Safavimirmahalleh M., 2012. Bacterial pathogens and resistance patterns in children with community-acquired urinary tract infection: a cross sectional study. J Comprehensive Pediatrics. 3, 16-20.


19. Rai G.K., Upreti H.C., Rai S.K., Shah K.P., Shrestha R.M., 2008. Causative agents of urinary tract infections in children and their antibiotic sensitivity pattern: a hospital based study. Nepal Med Coll J. 10(2), 86-90.


20. Song S.H., Kim K.S., 2008. Antibiotic prophylaxis in pediatric urology. Indian J Urol. 24(2), 145–149.


21. Mortazavi F., Shahin N., 2009. Changing patterns in sensitivity of bacterial uropathogens to antibiotics in children. Pak. J. Med. Sci. 25(5), 801-805


22. Al-Omar S., 2008. Bacterial culture results and susceptibility test of uropathogens isolated from outpatients referred from clinics in community. Tashkhis al-Mukhtabari. 3(7), 141-146.