Antimicrobial Sensitivity Pattern of Bacteria Isolated from Urine in a Pediatric Hematology Oncology Department: A Single Institutional Study

Background: Urinary tract infections (UTIs) may present with nonspecific symptoms and without any definitive clinical signs other than fever, hence may be missed without a routine urine analysis. We prospectively evaluated all cases of culture-positive urine infections in pediatric hematology oncology department of Dhaka Medical College Hospital (DMCH). Materials and methods: All positive urine culture incidents for pediatric cancer patients receiving treatment during the year July 2020 to August 2022 were included in this study. Analysis was performed on patients with regards to clinical, microbiology and pertinent lab findings. Results: There were 24 episodes of documented positive urine cultures among 17 patients. Most of the patients were febrile on the day of culture (87.5%) Majority of positive urine cultures were found in solid tumor patients (54.17%). Most commonly detected organisms were Gram-negative (91.67%), with E.coli being the most frequent (62.5%), followed by klebsiella (16.66%). Colistin sulphate, tigecycline, nitrofurantoin, meropenem were the most sensitive against Gram negative bacteria and the entire isolated Gram positive bacteria were 100% sensitive to amoxicillin, vancomycin, linezolid and nitrofurantoin. Conclusions: Positive urine culture in children with cancer sometimes may not be associated with urinalysis abnormalities only. When selecting empiric treatment for cancer patients with UTIs, one should take into consideration the institutional antibiotic sensitivity pattern.