Bacteriology of urinary tract infection and antimicrobial sensitivities in under-five children in Enugu

Abstract

Background: Urinary tract infection (UTI) is one of the serious bacterial infections in febrile young children, which may cause chronic morbidities. Studies from different parts of Nigeria have shown varying pattern in its
bacteriology and antibiotic sensitivities. Antimicrobial resistance rate among uropathogens is an increasing problem limiting therapeutic options, and underscores the need to determine local bacteriological pattern that will guide empiric antibiotic choices.
Objectives: To identify the bacterial pathogens responsible for UTI in febrile under-five children in Enugu as well as their antibiotic sensitivity patterns.
Methods: A cross-sectional descriptive hospital based study of eligible febrile children aged one to 59 months. Urine samples were collected using mid-stream and suprapubic aspiration methods. Standard laboratory  procedures were used to culture the urine specimens, identify the bacterial
pathogens as well as their antibiotic sensitivity patterns. Descriptive statistics were used to analyse the outcome.
Results: Significant bacteriuria occurred in 22 (11%) of the 200 samples. Escherichia coli isolates were the most common organisms in 7(31.8%) of the 22 positive samples. Others were Staphylococcus aureus, Klebsiella spp and Streptococcus faecalis isolated in 5 (22.7%), 3(13.6%), and 3(13.6%)
of the positive samples respectively. Most of the isolates were sensitive to ofloxacin (90.9%), ciprofloxacin (81.8%), nitrofurantoin (77.3%) and ceftriaxone (72.7%). High levels of resistance to ampicillin, cotrimoxazole,
amoxicillin, nalidixic acid and clavulanate-potentiated amoxicillin were observed.
Conclusion: Escherichia coli is the most common cause of UTI in febrile under-five children studied. Ciprofloxacin and ceftriaxone showed better sensitivities are advocated for the empiric treatment of febrile UTI in Enugu.

Key words: UTI, under-fives, bacterial pathogens, antibiotic sensitivities