Pediatric urinary tract infections in a tertiary care center from north India.
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Date
2010-01
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Abstract
Background & objectives: Paediatric urinary tract infections (UTI) are associated with high morbidity
and long term complications like renal scarring, hypertension, and chronic renal failure. A cause of
occult febrile illness, they often remain undiagnosed. We studied the clinical and microbiologic profile
and antibiotic resistance profile of such infections in paediatric UTI patients at our center.
Methods: Clean catch mid-stream urine samples for culture were received from 1974 children aged
< 12 yr over a period of 6 months. Quantitative wet mount microscopy and semiquantitative culture
on cysteine lactose electrolyte deficient medium were done to diagnose UTI. Isolates were identified by
standard biochemical tests and antimicrobial sensitivity was determined. Clinical details including risk
factors and underlying illness were noted.
Results: Significant bacteriuria was found in 558 children (28.3%). Male gender (25.6%), age < 1 yr
(77.5%), vesicoureteric reflux disease (VUR) (19.9%) and posterior urethral valve (PUV) (27.6%) were
common risk factors in children suffering from UTI. Pyuria was detected in 53.6 per cent of infections.
Common uropathogens isolated were Escherichia coli (47.1%), Klebsiella spp. (15.6%), Enterococcus
fecalis (8.7%), members of tribe Proteae (5.9%), Pseudomonas aeruginosa (5.9%) and Candida spp.
(5.5%). Against lactose fermenting Enterobacteriaceae, in-vitro resistance was least against amikacin
(32.5%), nitrofurantoin (26.7%) and imipenem (3.7%). Among enterococci, vancomycin resistant
enterococci constituted 12 per cent of the strains. 93.4 per cent of the UTI detected was nosocomial.
Interpretation & conclusion: Paediatric UTI was common in children with male gender, age < 1 yr, and
in children suffering from VUR and PUV. Spectrum of pathogens causing paediatric UTI in our center
had a preponderance of nosocomial multi-drug resistant pathogens.
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Keywords
Escherichia coli, Klebsiella spp., paediatric, uropathogens, UTI
Citation
Taneja Neelam, Chatterjee Shiv Sekhar, Singh Meenakshi, Singh Surjit, Sharma Meera. Pediatric urinary tract infections in a tertiary care center from north India. Indian Journal of Medical Research. 2010 Jan; 131(1): 101-105.