Efficacy of urine screening and culture methods in childhood urinary tract infections and analysis of the causative pathogens

Kavitha J., Anuradha D., Aravind M. A., Ganesh J.


Background: Urinary tract infection (UIT) is common in infants and children causing significant morbidity and long- term complications. In infants and young children symptoms and signs of UTI tend to be non-specific A presumptive diagnosis can be supported with a microscopic examination of a urine specimen. Definitive diagnosis requires a semi-quantitative culture of urine. There has been growing interest in developing efficient technology, that can rapidly and accurately diagnose UTIs and guide the clinician on antibiotic preference for maximum therapeutic benefit.

Methods: This prospective hospital-based study was conducted in patients from 2-12 years in a tertiary care hospital. Screening and confirmation of urinary tract infections by urine microscopy and urine culture and comparison, with an analysis of the bacterial strains and antibiotic sensitivity patterns was also done.

Results: Among the 214 culture positive patients analysed in the study 64 were 2-5years of age and 150 belonged to 5 -12 years. 128 (59.5%) were boys and 86 (40.2%) were girls. Proteinuria was observed in 68 children (31.8%). Significant pus cells of >5/hpf was present in 77 (36%). E. coli was the commonest organism in 98 children (45.8%) with 100% of organisms were sensitive to amikacin.

Conclusions: Over the years, the causative organisms of UTI in India have remained fairly constant but drug sensitivity has changed according to antibiotic usage. In the present era, the emergence of resistant strains poses a significant threat that can be ameliorated by rational and judicious antibiotic use. 


Antibiotics, Culture, Organisms, Urinary infection

Full Text:



Jian F, Linda M. Dairiki Shortliffe; Urinary tract infection in children: etiology and epidemiology, USA Urologyl Clin N Am. 2004;31:517-26.

Shaikh N, Morone NE, Bost JE, Farell MH; Prevalence of urinary tract infection in childhood: A meta-analysis Paediatric Infec Dis J. 2008;27:302-8.

Hay A, Whiting P, Butler C. How Best to diagnose urinary tract infection in preschool children in Primary care? BMJ. 2011;343:d6316.

Lambert H, Coulthard M. Webb N and Postlethwaile R. The child with Urinary tract infection Clinical Paediatric Nephrology. 3rdedition. Oxford University press: USA; 2003:197-226.

Subcommote on Urinary Tract Infecction. Practice Parameter: The diagnosis, treatment and evaluation of the initial urinary tract infection in febrile infants. Pediatric. 1999;103.:843-52.

Shaw KN, Gorelick M, McGowan KL, Yakscoe NM, Schwartz JS. Prevalence of urinary tract infection in febrile young children in the emergency department. Pediatrics. 1998;102(2):e16-.

Steele RW. The epidemiology and clinical presentation of urinary tract infections in children 2 years of age through adolescence. Pediatr Annals. 1999 ;28(10):653-8.

Riccabona M. Urinary tract infections in children. Curr Opin Urol. 2003;13(1):59-62.

Schalger TA. Urinary tract infections in children younger than 5 years of age. Paediatric Drugs. 2001;3(3):219-27.

Roberts KB. Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128:595-610.

Lavelle JM, Blackstone MM, FunariMK, et al; Two-step process for ED UTI screening in febrile young children:reducing catheterization rates. Pediatrics. 2016;138(1):e20153023.

Hoberman A, Wald ER, Reynolds EA, Penchansky L, Charron M. Pyuria and bacteriuria in urine specimens obtained by catheter from young children with fever. J Pediatr. 994;124:513-9.

Sharma A, Shrestha S, Upadhyay S, Rijal P. Clinical and Bacteriological profile of urinary tract infection in children. at Nepal Medical College Teaching Hospital Department of Pediatrics, Nepal Medical College, Kathmandu, Nepal Med Coll J. 2011;13:24-6.

Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in JNMC Hospital Aligarh, India. Annals of clinical microbiology and antimicrobials. 2007;6(1):4.

Mantadakis E, Tsalkidis A, Panopoulou M, Pagkalis S, Tripsianis G, Falagas M, et al. Antimicrobial susceptibility of pediatric uropathogens in Thrace, Greece. Internat Urol Nephrol. 2011;43(2):549-55.

Islam MN, Khaleque MA, Siddika M, Hossain MA. Urinary tract infection in children in a tertiary level hospital in Bangladesh. MMJ. 2010;19(4):482-6.