Significant bacteriuria in children with sickle cell anaemia in a Nigerian tertiary hospital

Abstract

Background: Urinary tract infections (UTI) in children with sickle cell anemia (SCA) may result in long term morbidity and mortality due to chronic renal
dysfunction.

Objectives: To evaluate the prevalence of significant bacteriuria among children with SCA and to determine their antimicrobial sensitivity patterns of isolates.

Methods: Two hundred and seventy two children with SCA in steady state (n = 185) and in crises (n = 87) aged 6 months to 15 years had their urine samples screened for significant bacteriuria. The urine samples were collected aseptically and incubated aerobically at 37‹C for 24 hours.
Children whose urine samples yielded .105cfu/ ml of bacteria on two consecutive cultures were regarded as having significant bacteriuria. The antimicrobial sensitivity pattern of isolates was determined.
Results: Significant bacteriuria was detected in 22 (8.1%) of the 272 subjects, 156 boys (57.4%) and 116 (42.6%) girls. The prevalence of significant bacteriuria was higher among those in crisis, 18 (20.7%) than among those in steady than, 4 (2.2%) state: ƒÔ2 = 27.323, p = 0.001. The most common organism isolated was Escherichia coli, 11 (50.0%). The
antibiotic with the best sensitivity was ceftriaxone. Most organisms were resistant to the commonly used ant ibiot ic s l ike cotrimoxazole, amoxicillin and ampicillin.
Conclusion: The prevalence of significant bacteriuria was found to be higher in SCA subjects in crisis (20.7%) than among those in steady state (2.2%). The most prevalent urinary pathogens were sensitive to ceftriaxone but resistant to commonly used antibiotics.

Keywords: Sickle Cell Anaemia, Children, Prevalence, Significant Bacteriuria