Cystitis in pediatric age group and its empirical therapy in a coastal region of southern India

Authors

  • Shobha K.L Department of MicrobiologyMelaka Manipal Medical CollegeManipal CampusManipal UniversityManipal
  • Middle name

Published:

2023-11-30

Abstract

Cystitis in childhood, is a common health issue causing morbidity and mortality. This study was to find out the bacterial pathogens causing cystitis in children and its susceptibility pattern. 1792 urine specimens from 1day- 18 years of age suspected of cystitis were obtained. Samples were inoculated into culture plates. Identification of the pathogens was by MALDI-ToF mass spectrometry and antimicrobial susceptibility testing by VITEX 2 system (bioMerieux,Inc, Durham, NC). 48.38% were males and 51.61% were females, 65% attended outpatient department and 35% were admitted in the hospital. Cystitis was more frequently seen in less than one year. Samples when on inoculation into the culture plates, had no organisms in 69.31% and 30.69% had significant bacteriuria. Bacteriuria among boys was more frequently seen in the age group of less than one year of age (35.06%) in the females, bacteriuria was more commonly seen in the age group of 1-5 years (28.32%). Escherichia coli 63.45% was the commonest pathogen isolated. Susceptibility to Trimethoprim/sulphamethoxazole was 84.53% and Ampicillin 45.56% .Since Trimethoprim/sulphamethoxazole is an FDA approved and cost effective drug, it could be an empirical drug of choice for treating cystitis in children of more than 6 weeks of age in the developing countries.

 

References

L. P. Jadresić : Diagnosis and management of urinary tract infections in children: Paediatrics and Child Health,2010: vol. 20, no. 6, pp. 274–278, https://doi.org/10.1016/j.paed.2010.02.004.

SaikhN, MoroneNE, BostJE, FarrellMH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J 2008; vol 27(4) pp.302-308 https://doi.org/10.1097/INF.0b013e31815e4122.

F. Mortazavi and N. Shahin: Changing patterns in sensitivity of bacterial uropathogens to antibiotics in children: Pakistan Journal of Medical Sciences: 2009: vol. 25, no. 5, pp. 801–805.

R. S. Edlin, D. J. Shapiro, A. L. Hersh, and H. L. Copp, “Antibiotic resistance patterns in outpatient pediatric urinary tract infections,” The Journal of Urology,2013, vol. 190, no. 1, pp. 222–227. https://doi.org/10.1016/j.juro.2013.01.069.

Nair BT, Rai AK: Prevalence of urinary tract infection in febrile children <2 years of age. Sahel Med J 2018; 21: 47-51 https://doi.org/10.4103/smj.smj_57_16.

C. J. Clark, W. A. Kennedy, and L. D. Shortliffe, “Urinary tract infection in children: when to worry,” Urologic Clinics of North Ameri-ca,2010 : vol. 37, no. 2, pp. 229–241. https://doi.org/10.1016/j.ucl.2010.03.009.

Elder JS. Urologic disorders in infants and children. 1621–1625. In:Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 16th ed. Philadelphia: WB Saunders; 2000.

Hillary L. Copp, and Bogdana Schmidt, Work up of Pediatric Urinary Tract Infection: Urol Clin North Am. 2015 Nov; 42(4): 519–526. https://doi.org/10.1016/j.ucl.2015.05.011.

Palak Gupta, Jharna Mandal, Sriram Krishnamurthy, Deepak Barathi, Nandini Pandit: Profile of urinary tract infections in paediatric patients: 2015;141;4; 473-477 https://doi.org/10.4103/0971-5916.159299.

Christopher D Doern and Susan E Richardson : Diagnosis of Urinary tract Infection in Children: J Clin Microbiol.2006 Sep : 54 (9):2233-2242 https://doi.org/10.1128/JCM.00189-16.

Alexander KC Leung, Alex HC Wong, Amt AM Leung,Kam L Hon: Urinary Tract Infection in Children : Recent Pat Inflamm Allergy Drug Discov:2019, May,13(1) : 2-18 https://doi.org/10.2174/1872213X13666181228154940.

Eun Young Seo, Seung Man Cho, Dong Seok Lee, Sung Min Choi, Doo Kwun Kim, Clinical Study of Prevalence of Antibiotic Re-sistance of Escherichia coli in Urinary Tract Infection in Children: A 9-year Retrospective, Single Center Experience: Child kidney dis-eases :2017: vol 21(2)121-1217 https://doi.org/10.3339/jkspn.2017.21.2.121.

Duployez C, Robert J, Vachée A; ONERBA. Trimethoprim susceptibility in E. coli community-acquired urinary tract infections in France. Med Mal Infect. 2018 Sep;48(6):410-413. https://doi.org/10.1016/j.medmal.2018.03.010.

Wesolek JL, Wu JY, Smalley CM, Wang L, Campbell MJ. Risk Factors for Trimethoprim and Sulfamethoxazole-Resistant Escherichia Coli in ED Patients with Urinary Tract Infections. Am J Emerg Med. 2022 Jun; 56:178-182. https://doi.org/10.1016/j.ajem.2022.03.052.

Kemnic TR, Coleman M. Trimethoprim Sulfamethoxazole. [Updated 2022 Nov 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513232/.

Ho JM, Juurlink DN. Considerations when prescribing trimethoprim-sulfamethoxazole. CMAJ. 2011 Nov 8;183(16):1851-8. https://doi.org/10.1503/cmaj.111152.

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