Prevalence of Urinary Tract Infection in Children With Severe Acute Malnutrition Aged Between Six Months and Five Years and Their Antibiotic Sensitivity Pattern

Abstract

Objective This study was conducted to determine the prevalence of urinary tract infection in children with severe acute malnutrition (SAM) aged between six months and five years and to identify the causative organisms and their antibiotic sensitivity pattern. Study design This study was an observational cross-sectional study. Setting and participants The study was conducted in the Department of Paediatrics in a tertiary care hospital in India over a period of 18 months. A total of 140 children aged between six months and five years according to the World Health Organisation's criteria of severe acute malnutrition were included upon fulfillment of inclusion and exclusion criteria. Ultrasound of kidney, ureter, and bladder (USG-KUB) was also done to exclude children with any underlying anatomical anomaly. Intervention Detailed clinical examination was performed on each of the participants with emphasis on anthropometry. Relevant blood investigations were sent along with urine routine microscopy and culture sensitivity in all patients. Results The prevalence of urinary tract infection (UTI) in our study was 23.57%. The most common organism isolated was Escherichia coli found in 54.54% of cases, followed by Klebsiella in 24.24%. Other organisms isolated were Enterococcus in 12.12%, Pseudomonas aeruginosa 6.06% and Citrobacter in 3.03%. E. coli showed high sensitivity to imipenem (88.87%), meropenem (83.84%), nitrofurantoin (77.76%) and amikacin (72.23%). Overall these organisms showed good sensitivity to amikacin (60.06%), imipenem (66.6%), meropenem (63.63%) and nitrofurantoin (72.72%). Resistance to common antibiotics like ciprofloxacin, cefotaxime and cefuroxime was seen. Conclusion Children with malnutrition are at risk of UTI. Urine routine examination and urine culture should be performed in all these children before starting antibiotics. Selection of an antibiotic should be according to the local drug sensitivity data. These antibiotics should have good efficacy against gram-negative organisms.