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AIMS Evidence-based management and local antibiotic susceptibility pattern provides evidence to guide the development of urinary tract infection (UTI) treatments protocols decreasing the economic burden significantly. We aimed to investigate the aetiology and resistance pattern of bacterial uropathogens to commonly prescribed oral antibiotics (beta lactamase and fluoroquinolones) causing UTI and to recommend the most appropriate antibiotics. MATERIALS AND METHODS This study is cross sectional, retrospective study. We evaluated causative agents and antimicrobial resistance in urine, culture positive samples collected from July 2019 to June 2021 in a single hospital in Kathmandu, Nepal. To obtain urine samples, a midstream clean-catch method used in children who were toilet trained and transurethral catheterization performed in non-toilet-trained children. Urine samples were sent to the laboratory where they were inoculated using a 4 mm calibre loop on CLED (Cysteine Lactose Electrolyte Deficient) agar plate, and incubated at 37 °C for 18–24 h. Conventional methods (colony morphology, Gram stain) were opted. Different biochemical tests – catalase test, coagulase test and inoculation in Bile Esculin Agar was done for Gram-positive organisms, while Triple Sugar Indole (TSI) agar, Sulphide indole motility (SIM) agar, Simon's citrate agar and Christensen's urea agar were used for identification of Gram-negative bacilli. Significant growth was evaluated as ≥105 colony forming units (CFU)/ml of urine. Kirby-Bauer disc diffusion method was used to perform in vitro antimicrobial susceptibility tests in Mueller-Hinton agar plates. Total 13 drugs were tested for sensitivity pattern. To analyse resistance to antibiotics for different ages, subjects were divided into four age groups: Group I, 2 months - 1 year; Group II, 1 year - 5 year; Group III, 5 year - 10 year; Group IV, 10 year - 15 year. RESULTS Among 970 samples sent, a total of 230 positive urine cultures were identified, of which 116 (50.4%) were from girls and 114 (49.6%) were from boys. The most common age group was 2 months to 1 year (49.1%). The most common causative agent was Escherichia coli (49.1%) followed by Enterococcus faecalis (14.3%) and Klebsiella pneumoniae (11.3%). The overall resistance to Nalidixic acid (66%), Ceftriaxone (54.8%) Cefotaxime (48.3%) Ciprofloxacin (47.9%) and Co-trimoxazole (46.9%) was significant. The least resistance was for Chloramphenicol, Nitrofurantoin, and Norfloxacin was 9.5 %, 31.5 %, and 38.3 % respectively. Chloramphenicol (90.5%) was the most active agent against E. coli and Klebsiella, whereas Linezolid (92.7%) and cloxacillin (64.9%) was most active against Enterococcus and Staphylococcus species. CONCLUSION Escherichia coli was the most common causative agent of urinary tract infection in children. Nalidixic acid, Ceftriaxone, Cefotaxime, Ciprofloxacin and Co-trimoxazole had the highest resistance rates against urinary tract pathogens in our centre. For oral empirical antibiotic therapy, Chloramphenicol is the most appropriate choice for Escherichia coli and Klebsiella strains and Linezolid for Enterococcus species.

Background and Objectives: This study was aimed to provide baseline information on infant feeding knowledge, practices and hindering factors for proper feedings.Material and Methods: Among the 185 women with less than one year child coming on immunization clinic of health post of Chisapani Village Development Committee, infant feeding knowledge, practices were assessed by interviewing with semi structured questionnaire and focus group discussion.Results: Male children were more exclusively breastfed (33%) than female (27%) and exclusive breast feeding was lower in fifth and sixth month of age. All of them were aware that the baby should be fed only breast milk for 6 months, but the exclusive breastfeeding practice was found only in a very few mothers. Most of them had fed solid food after 3 months.Conclusion: Knowledge and practices on infant feeding do not go along despite the adequacy of knowledge due to the hindering factors like poverty, working mother, lack of support from family members and lack of support from the government infant. The gap between knowledge and practice can be lessened via informative activities on lactation management, endorsing policies and rights for mothers-infants relationship.

Background: Congenital tuberculosis is defined as infection acquired to a newborn from infected mother by Mycobacterium tuberculosis bacilli during the intrauterine period or during normal birth. Though tuberculosis infection is very common all over the world, congenital tuberculosis is rare and mortality is 50%. Nonspecific symptoms in congenital tuberculosis and difficulties encountered in the diagnosis of tuberculosis in general, make it difficult to reach a final diagnosis so congenital tuberculosis is generally known clinically during the first postnatal month. Maternal tuberculosis is common but congenital tuberculosis is rare and fatal. Also the clinical features are not specific but diagnosis is difficult. So screening of all pregnant ladies can help in early diagnosis and prevention of congenital tuberculosis.Methods: This article has been produced by analyzing various publications since 1998 till date, and by using search gear, pub med, hinari and google.Result: Around 350 cases have been reported so far from different part of the world. There is paucity of data from our part of world.Conclusion: The difficulties in diagnostic and therapeutic conduct of this disease, which are of great interest to public health, points to the need to develop specific protocols. MED Phoenix Volume (1), Issue (1) July 2016, Page: 19-22