Prevalence, Aetiology, and Antimicrobial Susceptibility Patterns of Urinary Tract Infection Amongst Children Admitted at Kilimanjaro Christian Medical Centre, Moshi, Tanzania

Abstract

Background: Urinary tract infections (UTIs) in the paediatric population are well recognised as a cause of acute morbidity and chronic medical conditions, such as hypertension and renal insufficiency later in adulthood. Although antimicrobial treatment of UTIs is simple, the disease is still largely misdiagnosed and mismanaged. Moreover, increasing resistance to conventional antimicrobials is eroding the success of empiric therapy. Objective: To determine prevalence, aetiological agents, and antimicrobial sensitivity patterns of UTIs amongst children admitted at Kilimanjaro Christian Medical Centre (KCMC). Methodology: A cross-sectional, hospital-based study was conducted at the KCMC Department of Paediatrics and Child Health between December 2013 and April 2014. All children ages 2 months to 14 years who were admitted in the paediatric ward during the study period and fulfilled study criteria were enrolled. Data were collected by structured questionnaires. A urine dipstick test was done to detect the presence of nitrites and leucocytes, and to perform microscopic analysis of leucocytes and bacteria. All positive cases with the urine dipstick were cultured to determine bacterial species and antimicrobial susceptibility. Urine culture is considered the gold standard to confirm UTI. Results: A total of 343 children enrolled in the study. Of these, 208 (60.6%) were male and 135 (39.4%) were female. The urine dipstick test was positive for leucocyte esterase and nitrate in 87 (25.4%) and 33 (9.6%), respectively, and urine microscopy showed leucocytes and bacteria by microscope in 38 (11.1%) and 24 (7.0%) samples, respectively. UTI was confirmed by culture in 11.4% (39/343) of the samples. Female children and children less than 24 months old had a higher prevalence of UTI (17% and 15.8%, respectively). Female sex (odds ratio [OR] 2.46, 95% confidence interval [

Microbiological Characterisation of Community-Acquired Urinary Tract Infections in Bagamoyo, Tanzania: A Prospective Study

“…For example, a study from Moshi in the north-eastern part of the country identified E. coli and Klebsiella spp. as the two predominant species causing UTIs [9], while E. coli was also the major pathogen in a paediatric study from Mwanza in the northern part of Tanzania [11]. Likewise, resistance to ampicillin and cotrimoxazole was high, but only 11% of E. coli isolates displayed resistance to ciprofloxacin, which is lower than we observed in our study.…”

“…In Tanzania, only a few studies on UTIs have been conducted, and these found that UTI was a common diagnosis in 18-to 50-year-old individuals presenting to an emergency department in Ifakara [8]. Of note, rather low susceptibility rates to commonly prescribed antibiotics, such as ampicillin and cotrimoxazole, were observed [9].…”

Prevalence and antimicrobial sensitivity pattern of urinary tract infection among children with cerebral palsy, Moshi, Tanzania

“…This is similar to studies performed elsewhere. 16 , 17 , 28 The higher proportion of incontinence observed in this study can be explained by the presence of a higher percentage of children aged between 2 and 4 years (53.5%) who are not bladder trained. Children with CP attain spontaneous bladder control at around 47 months of age.…”

“…Also, the observed prevalence in the current study could be influenced by the use of antibiotics at least 2 weeks before attending the rehabilitation center, due to various reasons that were reported by 18 of the respondents, The most used antibiotic was amoxicillin; this could have cleared off any organisms that could be isolated as it was observed in a previous study. 28 …”

“…The current study adds on the finding that E. coli in UTI is highly resistant to first-line antibiotics, co-trimoxazole and ampicillin, and is sensitive to ciprofloxacin and ceftriaxone, as has been found by other studies. 19 , 22 , 28 We rarely use quinolones in children, and ceftriaxone is used in hospitals when there is severe infection. Exposure to the first-line antibiotics is however frequent as they are commonly given in primary health facilities and can even be procured over the counter.…”