Microbiological profile and antibiotic resistance pattern of urinary tract isolates in febrile under-five children in North-Eastern Nigeria

Background: Urinary tract infections (UTIs) remain a common cause of childhood morbidity, if poorly treated or undiagnosed, could result in long-term  morbidities e.g. hypertension, failure to thrive and end-stage renal disease (ESRD). An appropriate antimicrobial susceptibility pattern is essential. Objective: The study determined the profile and antibiotic sensitivity patterns of bacterial strains isolated from febrile under-five children in Azare, North-Eastern Nigeria. Methods: 145 febrile under-five children seen in Federal Medical Centre Azare over six months(March to August 2008)were enrolled in a hospital-based prospective study. Urine obtained by midstream and suprapubic bladder aspiration was subjected to urinalysis, urine microscopy, culture and sensitivity. Results: Of the 145 subjects enrolled, 34(23.4%) had UTI;24(70%) males and 10(30%) females .Gram-negative organisms accounted for 67.6%, Gram-positive organisms 32.4% of isolates; Escherichia coli in 12 (35.3%) cultures; Staphylococcus aureus; 11 (32.4%); Klebsiella species; 8 (23.5%).The gram-  negative enteric bacilli had a high prevalence of resistance against ampicillin, amoxicillin, nalidixic acid, nitrofurantoin and co-trimoxazole. Conclusion: Escherichia coli was the most prevalent bacterial organisms isolated. Others were Klebsiella, Proteus and Pseudomonas species with  Staphyloccocus aureus the only Gram-positive. The most effective agents were ceftriaxone, ciprofloxacin and gentamicin. A higher prevalence of UTIs was  found in boys.