Abstract

Background: The present study analyzes the clinical profile, identifies the pathogenic distribution and their antimicrobial susceptibility pattern in childhood urinary tract infections in order to provide standard reference for the optimal use of antibiotics in Nepal. Methods: A hospital based cross section study was conducted among children suspected of urinary tract infection in Kanti Children#x2019;s Hospital over a period of six months from August 2012 to November 2012. A total of 1890both sexes, ranging from post natal period to 14 years of age were studied. The modes of presentation, laboratory investigation reports, which included urine routine microscopy, bacterial isolation with colony count from urine culture, antibiotic sensitivity pattern and multidrug resistant profile, were documented. Data were analyzed by the Chi Square Test. Results: Among 1890 urine samples, 300(15.88%) showed culture positive result: 256 gram negative organisms and 44 gram positive organisms. Among the positive growth samples 144(48%) were male patients and 156(52%) were female patients.; Escherichia coli was most common organisms isolated (52.33%), followed by Klebsiella spp (17.33%), Staphylococcus aureus(14%), Pseudomonas aeruginosa (4.33%), Proteus spp (3.67%), Citrobacter spp (3%), Acinetobacter spp(1.66%), Enterobacter spp and Hafnia alvei (1.33%), Streptococcus spp (0.66%) and Salmonella paratyphi B(0.33%). Nitrofurantoin was found to have the highest sensitivity (71.67%) amongst most bacteria. Amikacin, Norfloxacin and Gentamicin had sensitivity of 69%, 61.71% and 61.67% respectively. Pseudomonas aeruginosa was 100% sensitive to Tobramycin, Piperacillin and Imipenem. Though sensitivity to Vancomycin was tested to 44 cases it was 100% sensitive to Staphylococcus aureus and Streptococcus fecalis. Highest degree of resistance was noted with Ceftazidime (64%), Ofloxacin (61.33%), Ampicillin (60%), ciprofloxacin (55.67%), Cotrimoxazole (52%), Gentamicin (38.33%), Amikacin (28%) and