Clinico-bacteriological Profile and Antibiotic Sensitivity Pattern in Paediatric Urinary Tract Infections with Clinical Correlation at a Tertiary Care Hospital in Eastern Uttar Pradesh: A Cross-Sectional Study

Background: UTI is a very common bacterial infection in children, which causes a lot of morbidity if not diagnosed and treated in time. Empirical antibiotic therapy has become difficult due to the growing resistance of uropathogens, and the regular monitoring of bacteriological profiles and antibiotic susceptibility patterns is necessary to standardise the approach to antimicrobial use and guarantee patient care. The objective is to assess the clinico-bacteriological profile, to assess the antibiotic sensitivity pattern of pediatric U.T.I. and to correlate the antibiotic sensitivity pattern with the clinical presentation of the UTI. Material and Methods: Cross-sectional analytical study was carried out in Department of Pathology, Baba Kinaram Autonomous State Medical College and Associated Hospital, Chandauli, Uttar Pradesh for a period of 18 months. The total number of children included were 120 (aged 1 month to 18 years) who have been diagnosed with urinary tract infection based on culture. A structured proforma was used for the data collection of clinical details. Urine samples were subjected to culture, identification of bacterial isolates and susceptibility testing using Kirby–Bauer (K-B) disc diffusion method based on Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed using SPSS 26.0 and significant accepted as p value less than 0.05. Results: Of all the children (120), 65.0% were females and the highest incidence was seen in the age group of 1–5 years (40.0%). Most common presenting symptoms were fever (85.0%), dysuria (65.0%) and increased urinary frequency (56.7%). Escherichia coli was the predominant uropathogen (61.7%) followed by Klebsiella pneumoniae (16.7%). The aforementioned antibiotics, which exhibited the lowest resistance rates were meropenem (93.3%), amikacin (88.3%) and nitrofurantoin (85.8%). High resistance was found to ampicillin and cotrimoxazole. Multidrug-resistant and extended-spectrum β-lactamase-producing organisms (XDR- and MDR-organisms) were found to be significantly associated with recurrent UTI (p<0.05). Conclusion: Escherichia coli (E. coli) is still the most common pathogen responsible for Pediatric UTIs. The growing issue of antimicrobial resistance necessitates the need for culture-guided antibiotic therapy. There is need to have local bacteriological profiles and antibiotic susceptibility patterns monitored continuously to optimize empiric therapy and help to achieve better clinical outcomes in children with UTI.

Keywords: Pediatric urinary tract infection, Urinary tract infection, Escherichia coli, Antibiotic sensitivity, Antimicrobial resistance, Urine culture, Uropathogens, Clinical profile, Children, Cross sectional study.