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Category: Volume 08 Issue 03 March 2020
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Title: Bacteriological profile of multidrug resistant Gram negative bacilli causing urinary tract infection in paediatric age group in a tertiary care centre

Authors: Lijitha S.G, Resmi Rajan, Karthika S, Sabu Thomas

 DOI: https://dx.doi.org/10.18535/jmscr/v8i3.87

Abstract

   

Introduction: Urinary tract infection is among the most common causes of febrile illness in children. It can lead to complications including septicaemia, if appropriate therapy is not given. Drug resistance has emerged as a significant problem in treating UTI. Knowing the pattern of antimicrobial resistance will help the clinicians in prescribing antibiotics.

Aims and Objectives: To determine the proportion of multidrug resistant Gram negative bacilli causing urinary tract infection in paediatric age group, antibiotic susceptibility pattern and detection of genes conferring resistance.

Materials and Methods: This is a descriptive study in which a total of 480 Gram negative urinary isolates from children less than 12 years over a period of 1 year were included. Multidrug resistant isolates were subjected to phenotypic confirmatory tests for ESBL, MBL, AmpC. 104 randomly selected isolates were subjected to PCR for CTX, TEM, SHV and VIM genes.

Results: Majority of isolates were from males.72.9% of isolates were multidrug resistant. Majority of the isolates were E coli followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Proteus mirabilis, Klebsiella oxytoca, Proteus vulgaris and Citrobacter freundii. Acinetobacter baumannii had the largest number (76.9%) of multidrug resistant isolates. 47.2% of the MDR isolates were ESBL producers, 11.6% were AmpC producers  and 11.2 % were MBL producers. 85 % of the  ESBL producing isolates tested had CTX M gene and 22 % had TEM gene. 1 out of the 4 MBL producing Pseudomonas aeruginosa isolates tested had VIM gene.

Conclusion: The study emphasize the need for surveillance and development of local and paediatric specific antibiograms to reduce the growing resistance rates.

Keywords: ESBL, MBL, paediatric UTI, TEM, CTX- M.

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Corresponding Author

Resmi Rajan

Professor, Dept of Microbiology, Government Medical College, Calicut- 673008, Kerala