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Antibiotic Sensitivity Patterns of Uropathogens in Children: The Current Trend

Background: The emergence of antibiotic-resistant infections has led to increased health care costs and mortality among children. The purpose of this study was to determine the causative organisms responsible for urinary tract infection and their antibiotic sensitivity pattern among pediatric patients of Rawalpindi/Islamabad. 
Material and Methods: This cross-sectional study was carried out from June 2014 to June 2015, in the Department of Microbiology, Army Medical College, Rawalpindi, affiliated with the Military Hospital, Rawalpindi. About 270 urine samples of children with UTI were analyzed through Analytical Profile Index (API) 20E and biochemical test strips system. Their antibiotic susceptibility was determined by using standard techniques. Data were assessed and analyzed by SPSS version 17. 
Results: Most common uropathogen was Escherichia coli (61.48%), followed by Proteus (15.5), Klebsiella (12.3%), Pseudomonas (4.5%), Enterococcus (3.7%) and Enterobacter (2.5%). Gram-negative rods, were most sensitive to imipenem (100%), Gentamycin (86%) and Amikacin (78.3%). They were least sensitive to Ampicillin (4.2%) and Norfloxacin (5.5%). Gram-positive cocci showed highest sensitivity for Vancomycin (100%) while displayed relatively less sensitivity for Nitrofurantoin (61.2%) and Gentamycin (48.7%). Cephalosporins also showed increased resistance with only 14% of gram-negative rods showing sensitivity to Cefotaxime. These organisms were highly resistant to Penicillin, showing a sensitivity of only 12.4%. 
Conclusion: Decreased sensitivity against penicillin and cephalosporins is seen in uropathogens causing UTI in children. High sensitivity towards Nitrofurantoin makes this drug an empirical treatment in UTI.  Regular surveillance of the developing resistance in uropathogens due to inappropriate use of antibiotic is necessary to reduce complication in children with urinary tract infection.