TITLE:
Profile and Antibiotic Sensitivity of Acute Pyelonephritis in Children at Gabriel Toure Teaching Hospital, Bamako
AUTHORS:
Djénèba Konaté, Lala N’Driany Sidibé, Karamoko Sacko, Bakary Koné, Adama Koné, Aminata Doumbia, Fatoumata Tiero, Pierre Togo, Fatouamata Léonie Diakité, Abdoul Karim Doumbia, Belco Maiga, Fousseyni Traoré, Aamadou Touré, Hawa Diall, Mohamed Elmouhouloud Cissé, Adama Dembélé, Oumar Coulibaly, Yacouba Aba Coulibaly, H. Konaré, Isabelle Traoré, Guédiouma Dembélé, Issiaka Koné, Leyla Maïga, Ibrahima Ahamadou, Abdoul Aziz Diakité, Boubacar Togo, Mariam Sylla, Fatoumata Dicko-Traoré
KEYWORDS:
APN, Fever, Child, Bamako
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.10 No.1,
January
22,
2020
ABSTRACT: Background: Very common symptom in children, fever, perhaps a warning
sign of more or less severe pathology,
rapidly progressive, including an invasive bacterial infection such as acute
pyelonephritis (APN). The aim of this work was to study the bacteriological
profile and antibiotic sensitivity of APN in children. Methods:
A prospective study involving any infant or child aged 3 months to 15 years
with an acute fever (≥38°C) in which a urine test strip was performed in the
pediatric department of the teaching hospital Gabriel Toure between April 1st and May 15th, 2019 (45 days). Results:
124 children were included out of 244 febrile patients. Infants (3 - 23 months) predominated (52.8%) with
a sex ratio of 2. Seventy-five percent of children came directly
from home and 30.6% were on antibiotic prior to admission. The urine bag sample was taken in 55.6% and the urine was
macroscopically cloudy in 32.3%. Stigmas of urinary tract infection at the
urinary strip were present in 56.5%. Confirmation of acute pyelonephritis (APN)
by CytoBacteriological Urine Examination (CBUE) was 29% with Escherichia coli (63.9%) or Enterococcus faecalis (30.5%). Sensitivity was excellent for
ciprofloxacin and imipenem (100%). The overall resistance was greater for
gentamicin, cotrimoxazole, ceftriaxone, cefotaxime and amoxicillin-clavulanic
acid (Threshold: 17.9% - 95.6%). APN was associated with bacteremia in 2.8% with hospitalization
for 45.2% and mortality of 11.1% (due to severe acute malnutrition, severe
dehydration and multifocal infection). Conclusion:
The APN, daily activity of pediatrician in Bamako, is observed in one
third of febrile children associated with a major life-threatening
condition of risk factors, then the
likely antibiotherapy could be amikacin in our context.