Urinary Tract Infection in Children: An Update

Abstract

Background: A large number of children with Urinary Tract Infection (UTI) are seen in the community by general practitioners , but there is frequently delay in treatment and not all are referred for further investigations. There is evidence that many cases are misdiagnosed. It is important to optimize diagnostic and management strategies. Result: UTI is an important cause of acute illness, it may be a marker of underlying urinary tract abnormality. Bacteria causes the large majority of UTI in children- Escherichia coli is the most common (90%) bacterial cause. Urine culture & sensitivity is the gold standard for the diagnosis and mandatory for confirmation of UTI. On culture, a colony count of more than 105/ml organisms of a single species is considered confirmatory of UTI. But there is a strong recommendation that , presence of both pyuria and at least 50,000 Colony Forming Unit (CFU) / ml of a single uropathogen in an appropriately collected specimen makes the diagnosis . There is a recommended imaging schedule in childhood UTI to detect anatomical abnormality. Management depends on type of infection. There is no role of prophylactic antibiotics to prevent febrile recurrent UTI without VUR. Conclusion: UTI is a very common disease and may be associated with renal abnormalities and long term squeale. There is debate about best investigation and management strategies. The greatest potential for prevention of renal damage lies in increased awareness, better diagnosis and management of young children with UTI in primary healthcare. DOI: http://dx.doi.org/10.3329/bjch.v36i2.13085 Bangladesh J Child Health 2012; Vol 36 (2): 90-97

Bacteriological Profile of Urinary Tract Infection in Children of a Tertiary Care Hospital

“…5 Urine culture & sensitivity is the gold standard for the diagnosis of UTI. 6 On culture, a colony count of more than 10 5 colony forming units /ml organisms of a single species in midstream urine of girls and >10 4 CFU/ml organisms in boys are considered confirmatory of UTI. 7 A pure growth of ≥10 2 CFU/ml from catheterized urine sample or growth of any number of uropathogen from urine obtained by suprapubic aspiration is considered as significant bacteriuria.…”

“…7 A pure growth of ≥10 2 CFU/ml from catheterized urine sample or growth of any number of uropathogen from urine obtained by suprapubic aspiration is considered as significant bacteriuria. 5 Although E. coli has been reported to account for most of the cases of symptomatic UTI in children, 6,7 studies from some other parts of the world however, have shown a changing trend in the bacteriology of UTI. [8][9][10] The spectrum of etiologic agents causing UTI and their antimicrobial resistance pattern have been continuously changing over the years, both in community and in hospitals.…”

Risk Factors of urinary tract infection in preschool children in Dhaka, Bangladesh

“…e potential risk factors for UTI around the world were selected from different studies. [1][2][3][4][5][6][7][8][9][10][11][12] en, a sample of 20 questionnaire were conducted in early January as field test to only keep ten effective variables related to the study area (Dhaka). e questionnaire was designed with both open-ended (e.g.…”

“…Many studies 8,9,10 have been recently conducted in Bangladesh for UTI in children, however, those studies are either conduct a review or diagnosis of UTI from medical perspective. is study however, undertook to identify and measure magnitude of the potential risk factors of UTI in hospitalized children less than 5 years of age in Bangladesh using observational and statistical approach comparing cases against control groups.…”

“…Recent studies have added to the list other risk factors for urinary tract infection in children in developing countries including poor personal hygiene, circumcised child, thread warm infection, constipation, wiping from back to front catheterization. [6][7][8][9][10] Many of the factors mentioned are amenable to corrective measures and may help in reducing the alarmingly high global burden of UTI.…”