An observational study on emerging antimicrobial resistance pattern in urinary tract Infection in Nepalese children
Abstract
AIMS Evidence-based management and local antibiotic susceptibility pattern provides evidence to guide the development of urinary tract infection (UTI) treatments protocols decreasing the economic burden significantly. We aimed to investigate the aetiology and resistance pattern of bacterial uropathogens to commonly prescribed oral antibiotics (beta lactamase and fluoroquinolones) causing UTI and to recommend the most appropriate antibiotics.
MATERIALS AND METHODS This study is cross sectional, retrospective study. We evaluated causative agents and antimicrobial resistance in urine, culture positive samples collected from July 2019 to June 2021 in a single hospital in Kathmandu, Nepal. To obtain urine samples, a midstream clean-catch method used in children who were toilet trained and transurethral catheterization performed in non-toilet-trained children. Urine samples were sent to the laboratory where they were inoculated using a 4 mm calibre loop on CLED (Cysteine Lactose Electrolyte Deficient) agar plate, and incubated at 37 °C for 18–24 h. Conventional methods (colony morphology, Gram stain) were opted. Different biochemical tests – catalase test, coagulase test and inoculation in Bile Esculin Agar was done for Gram-positive organisms, while Triple Sugar Indole (TSI) agar, Sulphide indole motility (SIM) agar, Simon's citrate agar and Christensen's urea agar were used for identification of Gram-negative bacilli. Significant growth was evaluated as ≥105 colony forming units…
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