Profile of urinary tract infections in paediatric patients.

Publisher: Medknow Country of Publication: India NLM ID: 0374701 Publication Model: Print Cited Medium: Internet ISSN: 0971-5916 (Print) Linking ISSN: 09715916 NLM ISO Abbreviation: Indian J Med Res Subsets: MEDLINE

Publication: <2011- > : Mumbai : Medknow
Original Publication: New Delhi : Council Of Medical Research

Escherichia coli/*pathogenicity ; Urinary Tract Infections/*microbiology ; Vesico-Ureteral Reflux/*microbiology; Aminoglycosides/administration & dosage ; Cefoperazone/administration & dosage ; Child ; Child, Preschool ; Escherichia coli/isolation & purification ; Female ; Humans ; India ; Infant ; Infant, Newborn ; Male ; Meropenem ; Nitrofurantoin/administration & dosage ; Thienamycins/administration & dosage ; Urinary Tract Infections/drug therapy ; Vesico-Ureteral Reflux/drug therapy

Background & Objectives: This cross-sectional study was conducted at a tertiary care centre in Puducherry, south India, with the aim of finding the profile of the paediatric urinary tract infection (UTI), bacterial pathogens involved, and also to observe vesicoureteric reflux (VUR) and renal scarring in these patients.
Methods: A total of 524 paediatric patients ≤13 yr, suspected to have UTI, were included in the study. Urine samples were collected, processed for uropathogen isolation and antibiotic susceptibility test was performed as per the Clinical and Laboratory Standards Institute (CLSI) guidelines. Thirty two culture proven children with UTI underwent micturating cysto-urethrography (MCU) and dimercaptosuccinic acid (DMSA) scanning was done for 69 children.
Results: o0 f the 524 children, 186 (35.4%) had culture proven UTI with 105 (56.4%) being infants, 50 (27.4%) between 1-5 yr, 30 (16.12%) between 5-13 yr and 129 (69.35%) males. Posterior urethral valve (PUV) was noted in three, hydronephrosis in one, VUR in 18 and renal scarring in 33. VUR as well as renal scarring were more in males >1 yr of age. A significant association (P=0.0054) was noted with a combined sensitivity and specificity of these investigations being 83 and 90 per cent, respectively of the MCU and DMSA scans for detecting VUR. Escherichia coli was the most common pathogen isolated, sensitive to nitrofurantoin, followed by cefoperazone-sulbactam, aminoglycosides and meropenem.
Interpretation & Conclusions: Our results indicate that UTI varies with age and gender and extensive evaluation is required in boys over one year of age with UTI. This study also highlights the better efficacy of aminoglycosides, cefoperazone-sulbactam and nitrofurantoin in vitro compared with meropenem in Gram-negative uropathogens.

Erratum in: Indian J Med Res. 2015 Jun;141(6):850. (PMID: 26205035)

Am J Clin Pathol. 1966 Apr;45(4):493-6. (PMID: 5325707)
Arch Dis Child. 1989 Nov;64(11):1538-41. (PMID: 2604411)
Pediatr Clin North Am. 1997 Oct;44(5):1133-69. (PMID: 9326956)
Indian Pediatr. 1998 Dec;35(12):1197-209. (PMID: 10216696)
Indian J Med Res. 2004 Dec;120(6):553-6. (PMID: 15654142)
Pediatrics. 2011 Sep;128(3):595-610. (PMID: 21873693)
Clin Microbiol Rev. 2005 Apr;18(2):417-22. (PMID: 15831830)
Indian Pediatr. 2005 Jul;42(7):691-6. (PMID: 16085971)
Indian J Med Res. 2010 Jan;131:101-5. (PMID: 20167982)
Indian Pediatr. 2011 Sep;48(9):709-17. (PMID: 21992903)
Indian Pediatr. 2013 Jul;50(7):707. (PMID: 23942441)

0 (Aminoglycosides)
0 (Thienamycins)
7U75I1278D (Cefoperazone)
927AH8112L (Nitrofurantoin)
FV9J3JU8B1 (Meropenem)

Date Created: 20150627 Date Completed: 20160414 Latest Revision: 20201209

20231215

PMC4510729

10.4103/0971-5916.159299

26112850