Urinary tract infection in pediatrics patients in north India

Gupta, Sumit; Agarwal, Reshma; Bhooshan, Suneel; Agrawal, Anand; Goyal, Ankur

doi:10.9790/0853-1135862

Cited by 5 publications

(13 citation statements)

References 13 publications

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“…Males outnumbered females by a smaller proportion except in the 5-12 year age group with a male: female ratio of 1:1.3. The predominance of males in our study was not consistent with many previous reports where females, except during infancy, were more affected than the males 9,[13][14][15][16] . Reasons may be the smaller sample size and increased preference for seeking treatment for only the male child in certain communities.…”

Section: Discussioncontrasting

confidence: 99%

“…After fever (69.2%) and excessive crying/ irritability (29.1%), urinary symptoms like dysuria (27.7%) and increased frequency of micturition (27.7%) predominated. Other studies also indicated high association between fever and UTI [8][9][10][11][12][13][15][16][17] . According to the World Health Organisation (WHO), fever as a marker of UTI has a sensitivity of 80% and specificity of 40% 18 .…”

Section: Discussionmentioning

confidence: 99%

“…According to the World Health Organisation (WHO), fever as a marker of UTI has a sensitivity of 80% and specificity of 40% 18 . Many studies have shown significant proportion of patients presenting with dysuria [8][9][10]13,[15][16][17]19 . Straining and poor urinary stream were found mostly in male patients.…”

Section: Discussionmentioning

confidence: 99%

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Clinico-microbiological determinants of urinary tract abnormality following first culture proven urinary tract infection in children

Dagli

Vala

Modi

et al. 2018

Sri Lanka J Child Health

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Introduction: Clinico-microbiological factors would help clinicians in developing countries to optimize the use of radioimaging childhood urinary tract infection (UTI), especially in resource limited settings with financial constraints Objective: To study the clinico-microbiological profile and determine the association of renal tract abnormalities in children with their first documented UTI and to find out the clinicomicrobiological determinants of the anomalies. Method: This prospective study was carried out over a period of two years in a tertiary care teaching hospital at Ahmedabad, Gujarat after obtaining permission from institutional review board. A total of 65 children up to 12 years of age with first culture proven UTI, were recruited from the paediatric outpatient department (OPD), paediatric ward and neonatal intensive care unit (NICU) after obtaining parental consent. Results: Most (49.2%) patients belonged to the 1-5 year age group. There were 36 (55.4%) males. Fever (69.2%) was the commonest symptom followed by excessive crying (29.2%) and dysuria (27.7%). Of the 65 patients, 15.3% had complicated UTI, 29.2% required hospitalization and 4.6% had hypertension. Of male patients 91.7% were uncircumcised. Malnutrition was found in 57.9% of patients in the under 5 year age group. We found altered renal function tests (RFTs) in 6.1%, leucocytosis in 29.2% and pyuria in 35.2% patients. Escherichia coli caused 40% of the infections, followed by Klebsiella (29.2%). Renal abnormalities were found in 27 (41.5%) with statistically significant (p<0.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinico-microbiological determinants of urinary tract abnormality following first culture proven urinary tract infection in children

Dagli

Vala

Modi

et al. 2018

Sri Lanka J Child Health

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“…16 In contrast, a study done by Patel et al and Gupta et al, E. coli was found to be most sensitive to imipenem. 21,22 E. coli showed high resistance to cefuroxime (76.1%) and ceftriaxone (71.4%), followed by norfloxacin (61.9%).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of urinary tract infection and sensitivity pattern amongst children less than 3 years of age with fever in a tertiary care hospital in South Karnataka

Ponvelil

Gowda

Raj

2020

Int J Basic Clin Pharmacol

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Background: Antimicrobial resistance is a major concern especially in urinary tract infections in children as improperly treated urinary tract infections (UTIs) on long term can cause renal scarring in young children, which leads to long term morbidities like hypertension, chronic renal disease and pre-eclampsia. The empirical therapy for UTI varies regionally due to their varied sensitivities and resistance pattern. This study aims to facilitate policy making in empirical antibiotic therapy of pediatric patients with urinary tract infections.Methods: A cross sectional study, which included a group of 140 children’s (6 months to 3 years) with fever were included in the study. All patients with colony count >1 lakh CFU/ml or colony count >50,000 CFU/ml, with leukocyturia (>5 WBCs/HPF in centrifuged urine) or colony count >1000 CFU/ml with urinary symptoms were diagnosed to be positive for urinary tract infection.Results: The prevalence of UTI in febrile children less than 3 years in our study was 0.1%. Out of 140 patients with fever, 35 were UTI positive. E. coli was the most commonly isolated organism (60%), followed by MRSA (14.2%) and Enterococci (11.4 %). E. coli was found to be most sensitive to nitrofurantoin (85.7%), followed by gentamicin (61.9%) and norfloxacin (38%). E. coli showed high resistance to cefuroxime (76.2%) and ceftriaxone (71.4%). MRSA was found to be most sensitive to linezolid and vancomycin, and resistant to norfloxacin.Conclusions: The data shows the increased resistance of E. coli to commonly prescribed antibiotics like cefuroxime and ceftriaxone. So, this study shows the empirical treatment of UTI in our region and the importance of having antibiotic prescription policies in every region.

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“…High sensitivity of E. coli to Imepenem has also been documented by Patel et al (100%), Gupta et al (96%) and Sharan et al (58%). [12][13][14] In present study, the pathogens which were commonly seen below 1 month of age were either Enterococci (2 cases) or E. coli (1 case). These neonates were in septicemia with intravenous lines that predisposed them to Enterococcal infection.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic sensitivity pattern of pathogens in children with urinary tract infection in a tertiary care hospital in Kachchh, Gujarat, India

Thaddanee

Khilnani

Shah

et al. 2017

Int J Contemp Pediatr

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Background: This prospective observational study was conducted in a tertiary care hospital in Kachchh, over a period of 6 months, to know the antibiotic sensitivity pattern of pathogens in children less than 18 years old with Urinary Tract Infection (UTI). Methods: Between December 2016 to June 2017, 186 children met the inclusion criterion. Urine samples were collected and processed for urine routine microscopy, culture and antibiotic sensitivity as per the standard laboratory guidelines. Urine culture was positive in 50 cases, which were further evaluated to find out any renal disease. All patients were given 10-14 days antibiotics course and follow-up urine reports were done. Patients were considered cured when the follow-up urine reports were normal. Results: E. coli was the commonest organism (34%) isolated, found mainly in 1-5 years age group (20%). Enterococci were isolated in 32% cases, most of which were less than 5 years of age (28%). Klebsiella (12%), Methicillin Resistant Staphylococcus Aureus (MRSA) (10%), Coagulase negative staphylococci (6%), Pseudomonas (2%) and Budding yeast cell (4%) were the less frequent organisms isolated. E. coli were found to be less sensitive to different Aminoglycosides (11.7% -23.5%), Cephalosporins (11.7% -52.9%), Fluoroquinolones (5.8% -11.7%), Cotrimoxazole (17.6%) and Piperacillin (17.6%), but were more sensitive (70.6%) to Imipenems. Enterococci were also partially sensitive to Aminoglycosides (6.2-18.7%), Cephalosporins (25-37.5.7%), Fluoroquinolones (6.25-12.5%), Penicillin-G (50%), Piperacillin (31.25%) and Co-trimoxazole (43.75%), but had good sensitivity for Imipenems (68.7%), Linezolid (75%) and Vancomycin (81.2%). Similarly, MRSA was 100% sensitive to Linezolid and Imipenem but partially sensitive (20-60%) to other antibiotics. Klebsiella showed 16.65-33.3% sensitivity to all antibiotics except Imipenem (83.3%) and was 100% resistant to Co-trimoxazole. Coagulase negative Staphylococci (CONS) remained 100% sensitive to all antibiotics and Pseudomonas was resistant to all antibiotics. Conclusions: The study concludes that pathogens for UTI in children have developed resistance, even to the newer generation antibiotics, probably due to the irrational use of antibiotics. In view of emergence of multi drug resistant pathogens, which carry considerable morbidity and mortality, every effort must be taken to use antibiotics judiciously.

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Urinary tract infection in pediatrics patients in north India

Abstract: Background -Urinary tract infection (UTI) is one of the most common bacterial infections

Cited by 5 publications

References 13 publications

Clinico-microbiological determinants of urinary tract abnormality following first culture proven urinary tract infection in children

Clinico-microbiological determinants of urinary tract abnormality following first culture proven urinary tract infection in children

Prevalence of urinary tract infection and sensitivity pattern amongst children less than 3 years of age with fever in a tertiary care hospital in South Karnataka

Antibiotic sensitivity pattern of pathogens in children with urinary tract infection in a tertiary care hospital in Kachchh, Gujarat, India

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