CLINICAL PROFILE AND OUTCOME OF URINARY TRACT INFECTIONS IN CHILDREN AGED 1-12 YEARS

Abstract

B. Manohar1, T. Jayachandra Naidu2, M. N. J. Sushma3, B. Sasi Kumar4, K. Sivaramudu5, V. S. Anjan Kumar6, L. Srividya7

BACKGROUND: Urinary tract is a common site of infection in the pediatric population. Unlike generally benign course of urinary tract infection (UTI) in the adult population, UTI in the pediatric population is well recognized as a cause of acute morbidity and chronic medical conditions like hypertension and renal insufficiency in adulthood. As a result, it is crucial to have a clear understanding of clinical profile of UTI in children.

AIMS AND OBJECTIVES: 1. to study the clinical presentation of UTI in children. 2. To identify the common microorganisms causing UTI in children. 3. To evaluate the risk factors for UTI in children.

SETTINGS AND DESIGN: Hospital based prospective study conducted from October 2010 to September 2011 in Department of Pediatrics at S.V.R.R Government General Hospital, a tertiary care hospital affiliated to S.V. Medical College, Tirupati, Andhra Pradesh.

METHODS AND MATERIAL: INCLUSION CRITERIA: All children in the age group of 1 to12 years admitted in hospital with a probable urinary tract infection and later confirmed by a positive urine culture.

EXCLUSION CRITERIA: Those children who received partial treatment with antibiotics prior to admission and those with any neurological abnormality of urinary bladder. Informed written consent was taken from parents of children and data was collected in pre-designed pro-forma.

RESULTS: Significant pyuria was present in all patients. Most common organisms isolated on urine culture were Escherichia coli and Klebsiella pneumoniae. Both were sensitive to third generation Cephalosporins, Piperacillin-Tazobactam and Amikacin. VUR was a significant risk factor for UTI (P<0.0001).

CONCLUSIONS: In children aged >1year, UTI is much more common in girls than boys. Escherichia coli and Klebsiella pneumoniae are the most common organisms causing UTI in children. Ultrasound examination of abdomen is a sensitive test to detect. Vesicoureteral reflux is a common predisposing factor for UTI in both boys and girls.

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