6076 High pervasiveness of multiple drug resistance among Escherichia coli infections in paediatric patients presenting to a tertiary care teaching hospital, Pakistan

Objectives Antimicrobial resistance is a major health risk. The number of infections caused by numerous drug-resistant microorganisms is increasing, making community-acquired infections a physician's nightmare. The aim of this survey was to assess the prevalence of multiple drug-resistant urinary tract pathogens affecting children Methods This survey was conducted in the Emergency Department of Holy Family Hospital/Rawalpindi Medical University, Rawalpindi, Pakistan over a period of one-year from March 2021 to March 2022. Urine samples were collected from children under five years of age. Urine samples were considered positive cultures when a single bacterial species with a colony count> 105 CFU/ml was grown. A total of 240 urine samples were collected, of which only 67 were positive. It was found that 67% and 18% of the infections were caused by E. coli and Staphylococcal species, respectively as shown in figure 1 Other bacteria that cause urinary tract infections include Klebsiella, Citrobacter, and Pseudomonas as shown in table 1. The antimicrobial susceptibility pattern of E. coli isolates was tested on 10 commonly prescribed antimicrobial drugs for urinary tract infections because E. coli was the predominant uropathogenic factor. Results About 66 percent of the isolates were resistant to 3 or more drugs. 46 percent of E. coli isolates were resistant to the 5 antibiotics tested. Augmentin (64%) showed the highest resistance. E. coli resistance to Norfloxacin and Cefuroxime was 60%. Approximately 94% of the isolates were sensitive to netilmicin. None of the investigated drugs were effective against all E. coli isolates. Conclusion This type of questionnaire can serve as a guideline for initiating the empirical treatment of community-acquired urinary tract infections pending the generation of culture reports.