Tools
Tools
Raya, Ganendra Bhakta, Dhoubhadel, Bhim Gopal, Shrestha, Dhruba, Raya, Sunayana, Laghu, Ujjwal, Shah, Ashok, Raya, Bijendra Bhakta, Kafle, Rita, Parry, Christopher and Ariyoshi, Koya (2020) 'Multidrug-resistant and extended-spectrum beta-lactamase-producing uropathogens in children in Bhaktapur, Nepal'. Tropical Medicine and Health, Vol 48, Issue 1.
|
Text
TMIH,CP.pdf - Published Version Available under License Creative Commons Attribution. Download (772kB) | Preview |
Abstract
Background
The emergence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing uropathogens has complicated the treatment of urinary tract infections (UTI). Paediatric UTI is a common illness, which if not treated properly, may lead to acute and long-term complications, such as renal abscess, septicaemia, and renal scarring. This study aimed to determine the prevalence of MDR and ESBL-producing uropathogens among children.
Methods
During the study period (April 2017–April 2018), midstream urine samples were collected following aseptic procedures from children < 16 years in Siddhi Memorial Hospital. Standard culture and biochemical tests were performed to identify uropathogens and antimicrobial susceptibility test was done by modified Kirby-Bauer disc diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines. ESBL-producing uropathogens were screened by ceftazidime (30 μg) and cefotaxime (30 μg) discs, and confirmed by the combination disc tests: ceftazidime + clavulanic acid (30/10 μg) or cefotaxime + clavulanic acid (30/10 μg) as recommended by CLSI.
Results
We processed 5545 non-repeated urine samples from the children with symptoms of UTI. A significant growth of uropathogens was observed in 203 samples (3.7%). The median age of the children was 24 months (interquartile range (IQR), 12–53 months). Escherichia coli (n = 158, 77.8%) and Klebsiella pneumoniae (n = 30, 14.8%) were common among the uropathogens. Among them, 80.3% were resistant to amoxycillin and 51.2% were resistant to cotrimoxazole. Most of them were susceptible to amikacin, nitrofurantoin, and ofloxacin. MDR was detected in 34.5% (n = 70/203) and ESBL producers in 24.6% (n = 50/203) of them. The proportion of MDR isolates was higher in children < 5 years (n = 59/153, 38.6%) than children ≥ 5 years (n = 11/50, 22%) (P = 0.03).
Conclusions
Nitrofurantoin, ofloxacin, and amikacin can be used for the empirical treatment for UTI in children in Bhaktapur, Nepal. MDR and ESBL-producing uropathogens are prevalent; this warrants a continuous surveillance of antimicrobial resistance.
| Item Type: | Article |
|---|---|
| Subjects: | QW Microbiology and Immunology > QW 45 Microbial drug resistance. General or not elsewhere classified. WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WJ Urogenital System > WJ 100 General works WS Pediatrics > WS 100 General works WS Pediatrics > Diseases of Children and Adolescents > By System > WS 320 Urogenital system |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1186/s41182-020-00251-6 |
| Depositing User: | Stacy Murtagh |
| Date Deposited: | 11 Aug 2020 11:44 |
| Last Modified: | 11 Aug 2020 11:44 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/15288 |
Statistics
Actions (login required)
 |
Edit Item |