Title: Clinical, Bacteriological Profile and Management Practices in Culture Positive Urinary Tract Infection in Children
Authors: Sharon Victoria Mendez, Jaidev M.D, Pavan Hegde, Habeeb Ullah Khan
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.103
Abstract
Introduction: Urinary tract infection (UTI) is seen in approximately 3-5% of girls and 1 % of boys. UTI can be the first presentation in 30% of children with urinary tract anomalies. Failure to identify these patients can result in damage to upper urinary tract and long term sequelae like renal scaring and hypertension.
Materials and Methods: Retrospective, time-bound case notes review over a period of one year of children with culture positive UTI admitted in Father Muller medical college hospital. Patient information was collected in a pre-structured and pre-validated proforma from case records. Mean, frequency, percentage, standard deviation were calculated for all descriptive data while continuous data was analysed using student’s t-test. P-value <0.05 was considered significant.
Results: A total of 40 children were included in the study. Majority of study subjects were females in the age group of 1-5 years (60%). Most common symptoms reported in children <5 years was fever (58%) and excessive cry while passing urine (58%) whereas 50% of children >5 years had complaints of pain abdomen. Previous history of UTI was present in 22% of subjects. Urine analysis had a sensitivity of 75% and specificity of 67%.The organism predominantly causing UTI continues to be E. coli (67%). Multidrug resistance was noted in 52.5% of isolates. In children less than 5 years, 88% of USGs were abnormal. All abnormal MCUs were in children below 5 years of age. Dimercaptosuccinic acid (DMSA) scan was abnormal in 50% of children in whom it was performed.
Conclusion: UTI in children presents with a wide variety of non-specific symptoms. UTI can be the first presentation of a child with genitourinary abnormalities. Urine microscopy can be used as a screening test in UTI. Abnormal USG and MCU studies are commonly seen in children less than 5 years with culture positive UTI hence imaging studies are warranted. There is increasing incidence of multidrug resistant strains causing UTI.
Keywords: UTI, Urine culture, Urine analysis, Genitourinary abnormalities, Imaging studies
