Introduction: Urinary tract infection (UTI) is common in children particularly girls. It usually presents with fever, rigors, urgency and increased frequency of micturition. Its diagnosis depends upon demonstration of sufficient quantity of organisms on microscopic examination and by culture sensitivity. Culture and sensitivity report not only provide with the confirmation of diagnosis but also help in managing the patients. We conducted this study to analyze clinical features and organisms involved in causing UTI in pediatric age group.

Materials and Methods: This was a prospective study in which patients under the age of 12 years. Urine samples from the patients suspected to be having UTI were collected from the patients and was sent for routine microscopic examination as well as for culture sensitivity Pediatric patients with culture proven urinary tract infections were included in this study on the basis of a predefined inclusion and exclusion criteria. Presenting complaints and culture sensitivity reports were analyzed. P value less than 0.05 was taken as statistically significant.

Results: Out of the 30 patients who had been diagnosed with UTI there were 20 females (66.66%) and 10 males (33.33%) with a M:F ratio of 1.72. The incidence of UTI was found to be more in female as compared to males and the difference was found to be statistically significant (P<0.05). Most common presenting complaint was found to be fever which was present in all patients (100%). The other presenting complaints were burning micturition (70%), abdominal pain (40%), rigors (36.66%), increased frequency (36.33%), urgency (33.33%), Loin pain (33.33%) and altered urine color (30%). Most common offending organism was found to be E. coli (46.67%) followed by Klebsiella (23.33%).

Conclusion: Urinary tract infection is one of the common causes of fever in children and must be ruled out in any child presenting with features suggestive of UTI. It’s appropriate diagnosis and prompt treatment are crucial to prevent complications such as renal scarring, pyelonephritis and sepsis.

Keywords: Urinary tract infection, Culture and sensitivity, Escherichia coli, antibiotics.

1. Schmiemann G, Kniehl E, Gebhardt K, Matejczyk MM, Hummers-Pradier E. The diagnosis of urinary tract infection: a systematic review. Dtsch Arztebl Int. 2010;107(21):361–367.
2. Najar MS, Saldanha CL, Banday KA. Approach to urinary tract infections. Indian J Nephrol. 2009;19(4):129–139.
3. Doern CD, Richardson SE. Diagnosis of Urinary Tract Infections in Children. J Clin Microbiol. 2016;54(9):2233–2242.
4. Riccabona M. Imaging in childhood urinary tract infection. Radiol Med. 2016 May;121(5):391-401.
5. Madsen CJ, Møller ML, Zerahn B, Fynbo C, Jensen JJ. Determination of kidney function with 99mTc-DTPA renography using a dual-head camera. Nucl Med Commun.2013 Apr;34(4):322-7.
6. Mattoo TK. Vesicoureteral reflux and reflux nephropathy. Adv Chronic Kidney Dis. 2011;18(5):348–354. 
7. Park YS. Renal scar formation after urinary tract infection in children. Korean J Pediatr. 2012;55(10):367–370. 
8. Kang CI, Kim J, Park DW, et al. Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections. Infect Chemother 2018;50(1):67–100. 
9. Sharon Victoria Mendez, Jaidev M.D, Pavan Hegde, Habeeb Ullah Khan Clinical, Bacteriological Profile and Management Practices in Culture Positive Urinary Tract Infection in Children JMSCR Volume 06 Issue 12 December 2018 630-634
10. Ashit Kumar, Ghazi S Ahmad, Kumar S Nath, Shreshy Singh, MD Arshad Alam Prevalence of urinary tract pathogen and its antimicrobial susceptibility pattern in children admitted in KMCH, Katihar, Bihar and compare its susceptibility pattern from national trend JMSCR Volume 06 Issue 10 October 2018 p 942-946
11. Jayavarthinni M, Madan S. Urinary Tract Infection among Inpatients: An Insight into Risk Factors and Antimicrobial Resistance. Ann. Int. Med. Den. Res. 2018; 4(2): MB01-MB05.
12. Dr J. Louis Ferdin Zeno, Dr M. K. Uthaya Sankar, Dr R. Gopal, Dr I. S. Suman Babu Study of Clinical profile and Antibiotic susceptibility of Urinary Tract Infection in a Tertiary Care Hospital JMSCR Volume 07 Issue 08 August 2019 342-351.
13. Rowe TA, Juthani-Mehta M. Diagnosis and management of urinary tract infection in older adults. Infect Dis Clin North Am. 2014 Mar;28(1):75-89. 
14. Ismaili K, Wissing KM, Lolin K, Le PQ, Christophe C, Lepage P, Hall M. Characteristics of first urinary tract infection with fever in children: a prospective clinical and imaging study. Pediatr Infect Dis J. 2011 May;30(5):371-4. 
15. Dr Dekyong Angmo, Dr Shaista Nazir, Dr Bashir A Fomda, Dr Shadan Akhtar Dr Shazia Benazir, Dr Asifa Bhat, Dr Leenah Bashir Microbiological Profile of Urinary Tract infections among Patients attending a Tertiary care Hospital  JMSCR Volume 06 Issue 06 June 2018 p 298-303.  

Dr Ajeet Gopchade [MBBS MD]

Consultant Pediatrician, Amrutpath Children Hospital Nanded (MS), India