Bacterial Profiles, Antibiotic Susceptibility Patterns and Associated Factors of Urinary Tract Infections among clinically Suspected Pediatric Patients in West, Central Ethiopia

Abstract

Background: Urinary tract infection (UTI) is a common bacterial disease in pediatrics. Objectives: To assess Bacterial Profiles, Antibiotic Susceptibility Pattern and Associated Factors of UTI among clinically Suspected Pediatric Patients in west, central Ethiopia from December 2022 to February 2023 Method: Health facility based cross-sectional study was conducted among 226 UTI suspected pediatric patients. Mid-stream urine sample was collected and inoculated in 5% blood agar and MacConkey agar, and biochemical tests were done for positive samples. Socio-demographic and associated factors were collected via face-to-face interviews. Antibiotic susceptibility test (AST) was done using disk diffusion method on Muller Hinton agar. Bivariate logistic regression was used to calculate odds ratio at 95% CI, and variables with P<0.25 were entered into a multivariate logistic model and a P-value< 0.05, at 95CI, considered as statistical significant. Result: A total of 226 pediatric patients were included in the study and 39 (17.3%) were culture positive for bacterial UTI. Gram- negative bacteria were predominant etiologic agents of UTI 34/40(85%). From the total 40 bacteria isolated, E. coli was the most frequently occurring bacteria isolates 28/40(70%), followed by Coagulase negative staphylococcus SPP. 4/40(10%) and K. pneumonia 3/40(7.5 %). Pediatric Patients with Previous admission [AOR :( 95%CI) =5.41(1.013–28.85) P=0.048], and uncircumcised male pediatric patients [AOR: (95% CI: 10.05(1.56–64.87) P=0.015] had statistically significant associations with culture-confirmed bacterial UTI. Isolated gram-negative bacteria were 100% susceptible to Meropenem and 78.2% were resistant to Ampicillin. From isolated gram-positive bacteria 100% were susceptible to Cefoxitin and gentamycin and 66.7% were resistant to Ampicillin. The overall multidrug resistance rate of the bacterial isolates was 65%. Conclusion: This study found a high prevalence of bacterial UTI, and it had statistically significant association with uncircumcised males and history of admission. The highest proportion of both gram positive and gram negative bacteria were resistant to ampicillin. A high proportion of MDR was observed, and antibiotic selection should be based on antibiotic susceptibility testing