Antibiogram of Extended-spectrum Beta-lactamase (ESBL) and Non-ESBL Producers in Urinary Tract Infections in Children: A Six-year Retrospective Study
Bhaskar Shenoy1*, Archana M2, Ranjeeta Adhikary3 and Bhavana MV4
1Professor and Head, Department of Pediatrics, Manipal Hospital, Bangalore, Karnataka, India
2Associate Consultant, Department of Pediatrics, Manipal Hospital, Bangalore, Karnataka, India
3Consultant and Head, Department of Microbiology, Manipal Hospital, Bangalore, Karnataka, India
4Consultant, Department of Microbiology, Manipal Hospital, Bangalore, Karnataka, India
*Corresponding Author: Bhaskar Shenoy, Professor and Head, Department of Pediatrics, Manipal Hospital, Bangalore, Karnataka, India.
December 22, 2021; Published: December 31, 2021
Objective: Urinary tract infection (UTI) is a common infection in children, due to the increased prevalence of antibiotic-resistant, extended-spectrum beta-lactamase (ESBL) and non-ESBL producers. Analyzing antibiotic sensitivity data and monitoring the changes in the susceptibility profiles is crucial for accurate diagnosis and treatment. This study aimed to retrospective analyze in vitro susceptibility profiles of gram-negative bacteria isolated in urine samples in a single institution.
Methods: Antibiotic sensitivity data were collected retrospectively from 1372 patients, aged 0-19 years, who were suffering from UTI. Data was analyzed for the prevalence of ESBL and non-ESBL producers. Wilcoxon Rank Sum Test, Chi-square test and odds ratios were used to compare the mean age, find the association and relative odds of having infection. Cochran-Armitage test was used to analyze the trend of antibiotic susceptibility test (AST) pattern. p- value of <0.05 was considered as statistically significant.
Results: A significant difference in the mean age and association between sex and ESBL and non-ESBL UTIs were noted (p < 0.05). Out of 1417 bacterial isolates from 1372 urine samples, E. coli (84.12%), followed by K. pneumoniae (12.63%) were the most predominant. Imipenem, meropenem, and ertapenem along with amikacin and netilmicin were highly effective against the ESBL producers; however, an increased resistance towards imipenem and meropenem was noted against non-ESBL producers (p < 0.001).
Conclusion: Carbapenems were effective against ESBL producers, along with amikacin and netilmicin. A declining AST pattern was observed for majority of antibiotics, except gentamicin against non-ESBL producers, suggesting the need for the practice of antibiotic stewardship.
Keywords: Antimicrobial Stewardship; Carbapenems; Child; Escherichia coli
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