Pediatric urinary tract infection as a cause of outpatient clinic visits in southern Ethiopia: a cross sectional study

Abstract

BackgroundFailure to timely diagnose and treat urinary tract infections is associated with grave long term consequences. The objectives of this study included assessing the proportion and predictors of Urinary Tract Infection (UTI) as a cause of pediatric outpatient department (OPD) visits and determining common uropathogens with antimicrobial susceptibility pattern.MethodsA cross sectional study was conducted from May to September 2015 among children of less than 15 years old at a tertiary center in Hawassa, Ethiopia. Children who fulfilled predefined eligibility criteria were recruited to undergo urine culture and urine analysis.ResultsA total of 863 children visited the OPD during the study period among which 269(31.2%) fulfilled the predefined eligibility criteria. Urine culture was positive for 74/269(27.5%) of the clinically suspected children. Male uncircumcision (adjusted odds ratio (aOR) 3.70; 95% CI 1.34–10.16) and under nutrition (aOR 5.41; 95%CI 2.64–11.07) were independent predictors of culture positivity. More than 5 WBC per high power field (aOR 4.7, 95% CI 1.8–12.7) on microscopy, urine PH > 5.0 (aOR 2.6, 95%CI 1.2–5.8), and positive leukocyte esterase (aOR 9.9, 95%CI 4.1–25.7) independently predicted positive growth on urine culture. Escherichia coli (34/74, 45.9%) and Klebsiella spp (18/74, 24.3%) were the most frequent isolates. High resistance was noted against amoxicillin (70.6%) and cotrimoxazole (97.1%) by E. coli.ConclusionUTI accounted for a tenth of total OPD visits. Commonly used first line antibiotics showed high level resistance to common etiologies of UTI. UTI should be suspected in febrile children, and antibiograms should be done to tailor prescription of antibiotics.

Bacterial profile, antibiotic susceptibility pattern and associated risk factors of urinary tract infection among clinically suspected children attending at Felege-Hiwot Comprehensive and Specialized Hospital, Northwest Ethiopia. A prospective study

“…It is in line with the study done in Addis Ababa 15.8% [18]. However, it is lower than the ndings of the studies in Gondar, 26.45% [19] and Hawassa, 27.5% [8]. This difference might be a female predominance to Gondar University Hospital (60.94%) in contrast to our study participants (44.8%).…”

“…Limited access to the drug, narrow-spectrum nature of the drug. However, it is 71.4% resistant to the nding in Hawassa Hospital [8]. Higher resistance to this antibiotic is perhaps due to their widespread and wrongly use as empirical therapy.…”

“…In Ethiopia, different studies were done in different study groups. a study done at Hawassa referral hospital in pediatric patients showed that the prevalence of UTI was 27.5% [8], and a prevalence of 15.9% and 26.45% was reported in Yekatit 12 hospital Addis Ababa [18] and Gondar University hospital [19]. But, in the study area, there is no study done on prevalence of UTI and associated factors among children.…”

“…Common symptoms of UTIs include burning sensation during urination, loss of bladder control, increased frequency of urination especially in small amounts, low back pain, cloudy and bloody or foul-smelling urine [7]. About 5% of girls and 2% of boys experience at least one incident of UTI up to the age of seven years [8,9]. Urinary tract infection is among the most prevailing infectious diseases with a consaiderable nancial burden on society.…”

Causes of fever in Gabonese children: a cross-sectional hospital-based study

“…E. coli was the most frequently isolated pathogen of urinary tract infections, as commonly seen in pediatric populations 23 . In stool samples, viruses were identified less frequently than in Tanzania 1 .…”