Abstract

Objectives: The primary objective was to analyze the clinical profile of infants admitted with Urinary Tract Infection (UTI), to study the adequacy of appropriate investigations and follow up these infants. The proportion having significant underlying abnormalities and the number requiring intervention was assessed.

Methods: All children less than one year of age, who were admitted with a diagnosis of Urinary Tract infection based on high urine WBC count or significant symptoms suggestive of UTI were included in the study. A retrospective chart review was performed and demographic data, clinical presentation, investigations and treatment details were noted. Outcome of investigations, need for antibiotic prophylaxis, breakthrough UTI and surgical interventions was noted. Data was statically noted.

Type of study-Retrospective study

Place of study: Hi-Tech medical college and Hospital, BBSR

Results: 219 children were enrolled. Urine culture was positive in 121(55.2%).Fever was the common presenting symptom in 89.9%,followed by crying during micturation in 41.1%  and vomiting in 40.6%,E.coli was the most common organism isolated in 78.5% children. Ultrasound of abdomen was done in 195/219 children of which 170(87%) were normal. Micturating Cystourethrogram (MCU) was done in37/219 children (16.8%) and showed Vesicoureteric reflux in 16(43.2%).Of the 29 children (13.2%) who underwent DMSA, 17 children had renal scarring. Antibiotic prophylaxis was started in 65 children (29.7%) but breakthrough UTI occurred in 41.6% and 35 children (15.9%) were referred to pediatric surgery for opinion and management.

Conclusions: Early detection of UTI’s early can prevent long term morbidity. Evaluation was not complete in the study cohort; hence underlying urological abnormalities may have been missed. MCU and DMSA need to be performed in infants even if ultrasound screening negative Better follow up of these infants is to be advocated.