Frequency and Antimicrobial Susceptibility Pattern of Urinary Tract Infections in Children Having Cerebral Palsy

Abstract

Objective: This study aimed to ascertain the frequency of UTIs, identify causative organisms, and assess their antimicrobial susceptibility among CP children at Children's Hospital, Lahore.
Material and Methods: This study was conducted over six months from February to August 2022, this was a cross-sectional study. The study was conducted at the Children's Hospital, Lahore (CHL). 125 CP children (aged 2-12 years, both genders) were evaluated for urinary tract issues. Isolated organisms underwent susceptibility testing against common antibiotics.
Results: CP children (mean age: 6.3±3.1 years) exhibited varying CP subtypes: spastic diplegia (35.2%), spastic hemiplegia (26.4%), spastic quadriplegia (22.4%), and dyskinetic CP (16.0%). UTIs were diagnosed in 34.4% of cases, predominantly caused by E. coli (53.5%), streptococcus fecalis (20.9%), Proteus Mirablis (14.0%), and Klebsiella (11.6%). Notably, E. coli, Proteus, and Klebsiella displayed 100% sensitivity to cipro- floxacin, ceftriaxone, cotrimoxazole, and gentamicin. However, susceptibility of streptococcus fecalis varied, being 100% sensitive to both ceftriaxone and ciprofloxacin, while exhibiting 55.6% sensitivity to cotrimoxazole and 66.7% to gentamicin.
Conclusion: A significant proportion of CP children exhibited UTIs primarily caused by E. coli and streptococcus fecalis, both fully susceptible to ceftriaxone and ciprofloxacin. These findings advocate for routine UTI screenings in CP children, emphasizing the preference for ceftriaxone and ciprofloxacin in managing positive cases.
Keywords: Cerebral palsy, urinary tract infection, antimicrobial susceptibility.