ANTIBIOTICS RESISTANT PATTERNS OF BACTERIA

CAUSING URINARY TRACT INFECTION IN CHILDREN WITH MALIGNANCY AT

DR. MOHAMMAD HOESIN HOSPITAL, PALEMBANG
Jayanthi Mandasari, Yulia Iriani

Department of Child Health Medical School, Sriwijaya University

Dr. Mohammad Hoesin Hospital, Palembang – Indonesia

ABSTRACT
Background: Urinary tract infection (UTI) is one of bacterial infections that can effect children
with malignancy. Antibiotic resistance of pathogenic bacteria causing UTI to one or more
antibiotics has been increasing in the last decade. This study is to determine the patterns of
antibiotics bacterial resistance in children with malignancy with urinary tract infections at dr.
Mohammad Hoesin Hospital, Palembang.
Methods: A retrospective descriptive study was conducted by reviewing medical records of
children with malignancy and had urine culture examination between January and December 2016.
Obtained data included causative bacteria and antibiotics resistance pattern.
Results: One hundred and thirty two children with malignancy were admitted to hemato-oncology
ward during the study period, 88 were male (66%). Mean age was 1.53 (SD 0.501) years. Diagnosis
were hematologic malignancy (65%) and solid tumor (35%) that included 99 children (75%) with
febrile neutropenia. Thirty-seven children (28%) had positive urine culture, mean age 1.41 (SD
0.498). 23 were male (23/37). Bacterial isolates showed that majority of gram-negative organisms
were Escherichia coli (40.5%), Klebsiella pneumoniae (18.9%), Pseudomonas aeruginosa (8.1%),
and other gram negative bacterias (16.3%), while for gram-positive, Streptococcus sp (8.1%),
Enterococcus sp (5.4%) and Staphylococcus sp (2.7%) were found. Escherichia coli was the
bacteria that causes the majority of UTIs and showed resistance to trimetropim-sulfamethoxazole
(87%), gentamicin (80%), cefotaxime (73%), and ciprofloxacin (67%). However, it is sensitive to
fosfomycin (80%), amikacin (73%) and chloramphenicol (67%). There was no difference in the
incidence of UTI between children with hematologic malignancy and solid tumor. There was no
difference in regard to age (t test, p=0.076) and sex (t test, p=0.226) between those who had positive
and negative urine culture.
Conclusion: UTI is commonly found in children with malignancy. It is affects a considerable
number of children with malignancy. Gram-negative bacteria were the predominant causative
pathogens, with Escherichia coli being the most frequently isolated.

Keywords: UTI, bacterial resistance, antibiotic sensitivity, malignancy, febrile neutropenia