Significant bacteriuria in children with sickle cell anaemia in a Nigerian tertiary hospital

Abstract

Background: Urinary tract infections (UTI) in children with sickle cell anemia (SCA) may result in long term morbidity and mortality due to chronic renal dysfunction. Objectives: To evaluate the prevalence of significant bacteriuria among children with SCA and to determine their antimicrobial sensitivity patterns of isolates. Methods: Two hundred and seventy two children with SCA in steady state (n = 185) and in cri-ses (n = 87) aged 6 months to 15 years had their urine samples screened for significant bacteri-uria. The urine samples were collected aseptically and incubated aerobically at 37°C for 24 hours. Children whose urine samples yielded ≥10 5 cfu/ ml of bacteria on two consecutive cultures were regarded as having significant bacteriuria. The antimicrobial sensitivity pattern of isolates was determined. Results: Significant bacteriuria was detected in 22 (8.1%) of the 272 subjects, 156 boys (57.4%) and 116 (42.6%) girls. The prevalence of significant bacteriuria was higher among those in crisis, 18 (20.7%) than among those in steady than, 4 (2.2%) state: χ 2 = 27.323, p = 0.001. The most common organism isolated was Es-cherichia coli, 11 (50.0%). The antibiotic with the best sensitivity was ceftriaxone. Most organisms were resistant to the commonly u s e d a n t ib io t ic s l i ke c o-trimoxazole, amoxicillin and am-picillin. Conclusion: The prevalence of significant bacteriuria was found to be higher in SCA subjects in crisis (20.7%) than among those in steady state (2.2%). The most prevalent urinary pathogens were sensitive to ceftriaxone but resistant to commonly used antibiotics.