www.ijcmr.com Section: Microbiology Section: Microbiology International Journal of Contemporary Medical Research Volume 7 | Issue 10 | October 2020 | ISSN (Online): 2393-915X; (Print): 2454-7379 J4 Antimicrobial Susceptibility Pattern of Various Etiological Agents Causing Pediatric Urinary Tract Infection Lautika Sonkar 1 , Rampal Singh 2 , Imran Ali 3 , Ved Prakash 4 , Deepika Verma 5 ORIGINAL RESEARCH ABSTRACT Introduction: Urinary tract infection (UTI) is one of the most common infections in children. The incidence of UTI varies with age and sex of the children. UTI is mainly due to ascending infection from the urethra. Timely diagnosis and treatment of UTI is important as it may be marker of urinary tract abnormalities, associated with high morbidity and mortality. Study aimed to determine the microbiological profile and their antimicrobial susceptibility pattern causing UTI among children. Material and methods: A total of 386 urine samples were collected from the suspected cases of UTI. A calibrated loop method (semi quantitative method) was used for the isolation of bacterial pathogens from urinary samples. Significant isolates were identified by conventional methods according to the standard laboratory protocol. The antibiotic sensitivity test was performed by modified Kirby Bauer disc diffusion technique as per CLSI. Result: A total of 386 urine samples from clinically suspected cases of UTI were enrolled in this study, out of which 138 (35.75%) showed significant growth and 248 (64%) were sterile. Out of 138 positive cases 77 (41.6%) were female and 61 (30.3%) were male. Majority of cases 43 (31.5%) were found in 0-5 years of age group. E. coli 61 (44.2%), and Staphylococcus aureus 45 (32.6%) was most common isolated Gram negative and Gram positive uropathogen among 138 positive cases. Gram negative organisms showed highest sensitivity to Nitrofurantoin (94.66%) while Gram positive organisms showed highest sensitivity to Nitrofurantoin (97.87%) followed by Vancomycin (91.46%). Conclusion: Regular monitoring of the antibiotic sensitivity pattern of UTI pathogens for commonly used antimicrobial agents should be carried out in a particular region for optimal empirical therapy. Keywords: Antimicrobial Susceptibility Testing (AST), Urinary Tract Infection (UTI). INTRODUCTION Urinary tract infection (UTI) is defined as the invasion of the genitourinary tract by the microorganisms, associated with high morbidity and mortality if left untreated. UTI is one of the most common infections in children. 1 The incidence of UTI varies with age and sex of the children. Approximately 5% of all children less than 2years of age have febrile illness due to UTI 2 , remains undiagnosed 3 , documented in cases associated with vesicoureteral reflex (VUR). 4 Post urethral valves, pelvi‑ureteric junction obstruction, neurogenic bladder, stricture urethra, vesicoureteral reflux are associated with pediatric UTI especially in infants (<1 year of age), differs all the way from adults. 5 The risk factors of UTI in children include low socioeconomic status, cultural habits like perineal cleaning method and diaper usage. 6 Small children are even more susceptible to have UTI which can be attributed to several predisposing factors such as changes in bacterial gut flora, immature immune system and urinary tract anomalies, among which vesicouretral reflex is the most common. VUR favors repeated infection and other complications like chronic pyelonephritis and eventual renal scarring. 7 Fever remains a most common presentation in neonates, infants and younger children, whereas older children present with classical sign of UTI. 8 Escherichia coli and Klebsiella spp. are the predominant pathogens though Enterococcus spp., yeasts and Staphylococcus aureus have emerged as prominent causative agents in recent years, many of them are resistant to multiple antibiotics. 5 Accurate diagnosis and appropriate treatment by antimicrobials is vital to treat the present infection as well as to prevent the possible long term consequences like renal scarring, hypertension and eventually end stage renal disease (ESRD). 9 Appropriate antimicrobial therapy should be started promptly for rapid recovery and the avoidance of complications. Treatment of UTI should be started before the culture results are available and then changed to culture specific therapy. Overuse and use of incomplete course of antibiotics as well as empirical antibiotic therapy have been the major contributing factors in the development of multidrug resistant bacteria. 10 Therefore, this study is undertaken to determine the microbiological profile and their susceptibility pattern causing UTI among children and to formulate guidelines for the empirical treatment of 1 Assistant Professor, Department of Microbiology, 2 Professor, Department of Anaesthesiology, 3 Medical Microbiology, Department of Microbiology, 4 Professor and Head, Department of Microbiology, 5 Professor, Department of Microbiology, Rohilkhand Medical College and Hospital, Suresh Sharma Nagar, Pilibhit Bypass Road, Bareilly, India Corresponding author: Dr Lautika Sonkar, Assistant Professor, Department of Microbiology, Rohilkhand Medical College and Hospital, Suresh Sharma Nagar, Pilibhit Bypass Road, Bareilly, India How to cite this article: Lautika Sonkar, Rampal Singh, Imran Ali, Ved Prakash, Deepika Verma. Antimicrobial susceptibility pattern of various etiological agents causing pediatric urinary tract infection. International Journal of Contemporary Medical Research 2020;7(10):J4-J8. DOI: http://dx.doi.org/10.21276/ijcmr.2020.7.10.23