Clinical, etiological and radiological profile of paediatric patients with urinary tract infection: a tertiary care hospital based prospective studypital based prospective study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20251477Keywords:
E. coli, HTN, USG, Urinary tract infectionAbstract
Background: Urinary tract infections are one of the most common bacterial infections, approximately 14% of pediatric emergencies are due to this cause. Prevalence varies with age, peaking in young infants, toddlers and older adolescents. Delayed recognition of UTI can lead to complications like renal scarring that can lead to HTN and chronic renal failure.
Methods: This study was a prospective observational study conducted on children from 6 months to 15 years of either sex. A total of 110 culture proven UTI cases were enrolled. After enrolling detailed history, physical examination and investigations were done. In all patients USG was performed and MCU was performed as per protocol.
Results: Among 110 children, majority were female. The most common symptom was fever followed by abdominal pain, vomiting, dysuria, excessive cry, frequency. Fever was present in all the age group while excessive cry, vomiting and lethargy was relatively m/c in age group<2 years. Whereas abdominal pain, dysuria, urgency and frequency was more common in age group>5 years. E. coli was the most common uropathogen, followed by Klebsiella and Enterococcus. USG findings were abnormal in 30 children and cystitis being the most common finding. MCU was performed in 36 children with abnormal findings in 12 children with VUR being the commonest.
Conclusions: The sex preponderance and clinical features varies with age. Greater index of suspicion is required when dealing with infants with fever at presentation, for a prompt diagnosis. USG helps in detection of structural abnormalities that can aid in early identification, intervention and prevention of potential complications.
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References
Del Villar OG, Peña KB. Urinary tract infection in pediatrics: Clinical approach and follow up. Salud Uninorte. 2018;34(1):203-11. DOI: https://doi.org/10.14482/sun.34.1.10745
Feld LG, Mattoo TK. Urinary tract infections and vesicoureteral reflux in infants and children. Pediatr Rev. 2010;31(11);451-63. DOI: https://doi.org/10.1542/pir.31.11.451
Almofarreh M, Alowaa Z, Junainah E, Alshahrani N, Alharbi M, Alkhalifahet W, et al. Prevalence of urinary tract infection among children. Int J Contemp Pediatr. 2018;5:2356–9. DOI: https://doi.org/10.18203/2349-3291.ijcp20183878
Jerardi KE & Jackson EC. Urinary tract infections. Nelson Textbook of Pediatrics. 21st Edition. Stanton KS (ed): Elsevier, Amsterdam. 2020: 2789-2795.
Wu CS, Wang SM, Ko WC. Group B streptococcal infections in children in a tertiary care hospital in southern Taiwan. J Microbiol Immunol Infect. 2004;37(3):169–75.
Chon C, Lai F, Shortliffe LM. Pediatric urinary tract infections. Pediatr clin N Am. 2001;48(6):1443. DOI: https://doi.org/10.1016/S0031-3955(05)70385-0
Twaij M. Urinary tract infection in children: a review of its pathogenesis and risk factors. J R Soc Health. 2000;120:220–6. DOI: https://doi.org/10.1177/146642400012000408
American Academy of Pediatrics, Committee on Quality Improvement, Subcommittee on Urinary Tract Infections. Practice parameters: The diagnosis, treatment and evaluation of the initial urinary tract infections in febrile infants and young children. Pediat. 1999;103:843-52. DOI: https://doi.org/10.1542/peds.103.4.843
Ramagopal G. Clinical and Microbiological Profile of Children with Urinary Tract Infection. J Ped. Nephrol. 2018;6(2):67-9.
Vijayakumar M, Kanitkar M, Nammalwar BR, Bagga A. Revised statement on management of urinary tract infections. Indian Pediat. 2011;48(9):709-17.
LINES GG. revised statement on management of urinary tract infections. Indian pediatrics. 2011;48:78.
Mandal AK, Jana JK, Chatterjee Y, Pradhan M, Mahata D, Mallick MS, et al. Clinical and microbiological profiles of urinary tract infections in febrile children aged six months to five years attending a tertiary care hospital in india. Cureus. 2024;16(1):67.
Bilal M, Nadeem MT, Jalal A, Ahmed I, Samad A. Clinico-laboratoryprofile and drug sensitivity pattern in urinary tract infection of children in a tertiary care hospital. J Rawalpindi Med College. 2023;27(3):78. DOI: https://doi.org/10.37939/jrmc.v27i3.2264
Badhan R, Singh DV, Badhan LR, Kaur A. Evaluation of bacteriological profile and antibiotic sensitivity patterns in children with urinary tract infection: A prospective study from a tertiary care center. Indian J Urol. 2016;1;32(1):50-6. DOI: https://doi.org/10.4103/0970-1591.173118
Manohar B, Naidu TJ, Sushma M, Kumar BS, Sivaramudu K, Kumar VA, et al. Clinical profile and outcome of urinary tract infections in children aged 1-12 years. J Evid Based Med Healthcare. 2015;4;2(18):2448-56. DOI: https://doi.org/10.18410/jebmh/2015/391
Malla KK, Sarma MS, Malla T, Thapalial A. Clinical profile, bacterial isolates and antibiotic susceptibility patterns in urinary tract infection in children–hospital based study. J Nepal Paed Soc. 2008;28(2):52-61. DOI: https://doi.org/10.3126/jnps.v28i2.1388
Vaidya SS, Gaikwad SY. Study of clinical etiological and radiological profile of UTI cases. IJCP. 2018;22:5. DOI: https://doi.org/10.18203/2349-3291.ijcp20181987
Kumar V, Singh RN, Verma PK, Bhat NK, Shrivastava Y, Yhoshu E, et al. Clinico-microbiological profile and clinical predictor of urinary tract infection in children: a single-center study from himalayan foothills. Cureus. 2023;3;15(1):67. DOI: https://doi.org/10.7759/cureus.33289
Behera CK, Nayak MK, Biswal SR, Swain N, Pattnaik S. Clinical profile and antibiotic sensitivity pattern in pediatric urinary tract infection of a tertiary care hospital in Bhubaneswar, Odisha. Indian J Public Health Res Dev. 2018;1:9. DOI: https://doi.org/10.5958/0976-5506.2018.01451.1
Yamamoto S, Tsukamoto T, Terai A, Kurazono H, Takeda Y, Yoshida O. Genetic evidence supporting the fecal-perineal-urethral hypothesis in cystitis caused by Escherichia coli. J Urol. 1997;157(3):1127-9. DOI: https://doi.org/10.1016/S0022-5347(01)65154-1
Cox CE, Hinman F. Experiments with induced bacteriuria, vesical emptying and bacterial growth on the mechanism of bladder defense to infection. The J Urol. 1961;86(6):739-48. DOI: https://doi.org/10.1016/S0022-5347(17)65257-1
Ghosh SK, Saha SK, Islam M. Etioclinical profile of urinary tract infection in children. J Medial Sci Clin Res. 2020;8(4):180-4. DOI: https://doi.org/10.18535/jmscr/v8i4.35
Rao KR, Gandhi SS, Kokiwar PR. Clinical study of urinary tract infection in children. Int J Contemp Pediatr. 2016;3:214-7. DOI: https://doi.org/10.18203/2349-3291.ijcp20160162
Mazzola BL, von Vigier RO, Marchand S, Tönz M, Bianchetti MG. Behavioral and functional abnormalities linked with recurrent urinary tract infections in girls. J Nephrol. 2003;1;16(1):133-8.
Gondim R, Azevedo R, Braga AA, Veiga ML, Barroso U. Risk factors for urinary tract infection in children with urinary urgency. International Braz J Urol. 2018;44(2):378-83. DOI: https://doi.org/10.1590/s1677-5538.ibju.2017.0434
Shrestha LB, Baral R, Poudel P, Khanal B. Clinical, etiological and antimicrobial susceptibility profile of pediatric urinary tract infections in a tertiary care hospital of Nepal. BMC Pediat. 2019;19(1):1-8. DOI: https://doi.org/10.1186/s12887-019-1410-1
Taneja N, Chatterjee SS, Singh M, Singh S, Sharma M. Pediatric urinary tract infections in a tertiary care center from north India. Indian J Medical Res. 2010;1;131(1):101-5.
Singh SD, Madhup SK. Clinical Profile and Antibiotics Sen- sitivity in Childhood Urinary Tract Infection at Dhulikhel Hospital. Kathmandu Univ Med J. 2013;44(4):319-24. DOI: https://doi.org/10.3126/kumj.v11i4.12541