Microbes and antibiotic susceptibility patterns of urinary tract infections in toilet-trained Children at a Tertiary Care Hospital of Sialkot, Pakistan.

Objective: To find out various types of microorganisms causing urinary tract infections and their antibiotic sensitivity patterns among toilet-trained children presenting at a tertiary care hospital of Sialkot District. Study Design: Descriptive study. Setting: Department of Microbiology/Urology, Khawaja Muhammad Safdar Medical College, Sialkot. Period: June to December 2019. Material & Methods: A total of 176 toilet trained children, aged 7 to 15 years, presenting in outpatient department and having culture positive urinary tract infections were enrolled. Demographic information like age, gender and area of residence along with clinical findings, antibiotic sensitivities and resistance patterns were recorded. Mid-stream urine sample was collected from all toilet-trained children and immediately sent to institutional laboratory for urine analysis and urine culture and sensitivities. Results: Out of a total of 176 children, 95 (54.0%) were female and 81 (46.0%) male. Overall mean age was noted to be 10.68+2.42 years while most of the children, 94 (53.4%) were above 10 years of age. Majority of the patients, 98 (55.7%) belonged to rural areas. Eschericia coli were the most common isolate, found among 140 (79.5%) children. Imipenem (98.9%), meropenem (98.9%), piperacillin tazobactam (97.7%), fosfomycin (96.6%), amikacin (95.5%), nitrofurantoin (84.4%), gentamycin (90.9%) and amoxicillin clavulanate (83%) were found to have the highest sensitivities. Conclusion: Eschericia coli were the most common bacterial urinary pathogens in toilet-trained children. Amoxicillin clavulanate, Nitrofurantoin and Fosfomycin available in oral form showed good sensitivity of 83%, 84.4%, and 96.6% respectively) to commonly found microorganisms. It was also noted that resistance to commonly used antibiotics in our region is rising.