Antimicrobial Susceptibility Pattern and ESBL Production among Uropathogenic Escherichia coli Isolated from UTI Children in Pediatric Unit of a Hospital in Kerman, Iran

Abstract

Emergence of antibiotic resistance and extended spectrum β-lactamase (ESBL) among uropathogens in the pediatric unit of hospitals created serious health care concern. This study deals with antimicrobial susceptibility and ESBL analysis of uropathogenic Escherichia coli isolated from children hospitalized in pediatric unit of a university hospital in Kerman, Iran. Methodology: Fifty five uropathogens positive samples were recovered from one hundred thirty five samples collected from urine of the children hospitalized with sign of UTI in pediatric unit of a hospital, in Kerman, Iran from April 2011 to November 2012. Preliminary antimicrobial susceptibility testing was carried out using agar disk-diffusion breakpoint assay and minimum inhibitory concentrations (MICs) of different antibiotics were determined using agar dilution method. ESBL production was detected by a double disk synergy test and confirmed by a phenotypic confirmatory test. Results: Of fifty five positive samples isolated, Escherichia coli (69%) was the leading uropathogen followed by Klebsiella spp. (18.8%), Proteus (7.27%), Staphylococcus aureus (3.63%), Citrobacter (1.8%), Enterobacter spp. (1.81%) and Enterococcus (1.8%). Antimicrobial susceptibility tests revealed that almost all uropathogenic E.coli were sensitive to carbapenems (100%) and amikacin (94.4%), while, 100% of the strains were resistant to ampicillin (MIC range ±32 µg/mL), 63.8% were resistant to amoxicillin/clavulanic acid (MIC range ±32µg/mL), 33% were resistant to trimethoprim-sulfamethoxazole (MIC range ±64.2µg/mL) and 61.1% of the strains were resistant to third generation of cephalosporins (MIC range ±8.0µg/mL) [P=0.05]. The ESBL confirmatory test for uropathogenic E.coli isolates resistant to third generation of cephalosporins revealed that only 20% were produced detectable ESBL enzymes. Conclusion: From above results it can be concluded that E.coli was the most common nosocomial pathogen associated with UTI among hospitalized children in our hospital and amikacin, carbapenems were very effective drugs for treatment of UTI in these age group, while, care must be taken when third generation of cephalosporins and trimethoprim-sulfametoxazole are administered.

Bacterial Pathogens and Antimicrobial Susceptibility Patterns of Urinary Tract Infections in Children during COVID-19 2019–2020: A Large Tertiary Care Center in Saudi Arabia

“…Regarding antimicrobial susceptibility, our study revealed that E. coli isolates were more sensitive to meropenem and ertapenem in 99.2% of cases, followed by amikacin (99%), nitrofurantoin (96.8%), and imipenem (95.2%). These findings are in agreement with previous studies [ 24 , 25 , 26 , 27 ]. And in disagreement with the study by Shar-iian et al in 2006 in Tehran, which reported that ceftriaxone (97.8%) and cefotaxime (95.2%) were the most sensitive antibiotics for E. coli [ 26 ].…”

The use of cinnamon oil as antibacterial agent to eliminate some antibiotic-resistant bacteria isolated from water sources

“…Similar results were reported by Shakibaie et al, 2014 who isolated E. coli from UTI children in the pediatric unit of a medical clinic in Kerman, Iran. Also, they found that 100% of isolates were sensitive to carbapenems, and 94.4% were sensitive to amikacin; all uropathogenic E. coli isolates were resistant to ampicillin (100%).…”

Comprehensive study of antimicrobial susceptibility pattern and extended spectrum beta-lactamase (ESBL) prevalence in bacteria isolated from urine samples

“…In another study by Mohammed et al, isolated E. coli was highly sensitive to Amikacin, Imipenem, and Meropenem, and extremely resistant to Ampicillin 42 . Shakibaie et al exhibited that uropathogenic E. coli were 100% sensitive to Imipenem and Meropenem, and 94.4% to Amikacin, while all of them were resistant to Ampicillin 43 . Another study conducted by Koshesh et al revealed a low rate of resistance to Imipenem for E. coli uropathogens 44 .…”