scholarly journals Clinical profile of pediatric patients with urinary tract infection in a tertiary care centre in Kashmir, India

2019 ◽  
Vol 6 (3) ◽  
pp. 1149
Author(s):  
Khalid Kawoosa ◽  
Rahid Rasool Malla ◽  
Sheeraz Ahmad Dar ◽  
Syed Heena Kubravi

Background: The urinary tract is a common site of infection in pediatric patients. Author studied the clinical and microbiological profile along with the antibiotic resistance in children with UTI attending centre.Methods: It was a prospective study was conducted in the Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India over a period of one year from August 2017 to August 2018.A total of 250 children aged 1-36 months were included in the study. A proper history and examination were done in each case. A clean catch mid-stream urine sample was obtained from each child. Quantitative microscopy and urine culture were performed. Standard biochemical tests were done to identify the isolates and for determination of antibiotic sensitivity.Results: Out of the 250 children studied , a total of 216 children were diagnosed as UTI by positive urine culture.102 were males and 114 were females. Significant pyuria was detected in 85%patients. Fever with irritability was the most common presenting symptom (71%) followed by vomiting (63%) and abdominal pain (52%).The most common uropathogen detected was E. coli (57%) followed by Klebsiella spp. (20%), proteus (16%), pseudomonas (5%), and candida (2%). Majority of the patients responded to treatment with ceftriaxone followed by cefixime. Antibiotic resistance in vitro was least seen with amikacin (25%) followed by nitrofurantoin (11%). 91.3% of UTI detected was nosocomial. Vesicoureteral reflux was found in 49% of patients while 13% were diagnosed with posterior urethral valve.Conclusions: Urinary tract infection should be considered as one of the most important differential diagnosis in patients with fever attending pediatric OPD. Urine microscopy and culture should be a part of routine diagnostic evaluation in all febrile children. Early treatment of UTI is important to prevent later sequelae including pyelonephritis and renal scarring.

2021 ◽  
pp. 71-73
Author(s):  
Nabanita Das ◽  
Mitali Bera ◽  
Shabarna Roy ◽  
Dhruba Kumar Mahata

Introduction: Urinary tract infection is the most common bacterial infection in childhood and upto 30% of infants and children experience recurrent infections during the rst 6 to 12 months after initial UTI. Urinary tract infections (UTI) imply invasion of urinary tract by pathogens, which may involve the upper or lower urinary tract depending on the infection in the kidney or bladder and urethra. Aims And Objectives: Children presenting with UTI by Ultrasonography, MCU and / or DMSA depending on the child's age. structural abnormalities and the presence of VUR if any in children with UTI by USG, MCU and DMSAscan in indicated cases. Materials And Methods: The study was conducted in the Pediatrics ward of Midnapore Medical College and Hospital. This is a tertiary care centre. Pediatric patients from different districts of West Bengal are referred to our Institute. All pediatric patients from 3 months to 12 years of age patients with a diagnosis of, either rst episode or recurrent UTI admitted at Midnapore Medical College and Hospital. Our study was an Observational, Prospective study. All the pediatric patients fullling the inclusion criteria, admitted to the hospital during the study period was enrolled for the study. Result And Analysis: We found in abnormal DMSA, the mean age (mean±s.d.) of children was 21.9375 ± 29.1398 years. In normal DMSA, the mean age (mean±s.d.) of children was 24.7321 ± 18.3179. In not required DMSA, the mean age (mean±s.d.) of children was 97.1667 ± 21.9855. Distribution of mean age in years vs. DMSAwas statistically signicant (p<0.0001). In abnormal DMSA, Conclusion: Even a normal USG report does not rule out dysfunctional bladder as we have had 3 children aged 19 months, 6 months and 26 months who had normal USG ndings but clear evidence of VUR on MCU of grades 2 ,4 and 1 respectively. In conclusion, abnormal US may carry a higher probability of grades III-VVUR and RS, and can affect the management in a signicant number of children hospitalized with UTI.


Author(s):  
Nandkishor Bankar ◽  
Dhruba Hari Chandi ◽  
Praful Patil ◽  
Gaurav Mahajan

Introduction: UTI occurs when bacteria that live inside intestine find their way into the urinary tract through the urethra. Women are familiar to be a lot of at risk of UTI than men, with a five hundredth probability of a UTI in their life. Aim: The aim of this study was to find the antibiotic resistance pattern in Escherichia coli isolated from urinary tract infection with commonly found antibiotics among different age and sex groups. Materials and Methods: All positive urine samples for Escherichia coli obtained from patients were included. On the basis of colony morphology and biochemical tests Isolates were identified. The antibiogram profile of the isolates was determined by commonly used antibiotics. Result: In this studied, total 250 patients with UTI of both sexes were included and divided into age group. Samples processed only 250 samples with the growth of E. coli were included in this studied. The isolated E.coli showed more resistant to some degree to all the antibiotics tested.  The greatest resistance was shown against Amoxycillin (15.2% isolated were sensitive) and the least resistance was shown against Imipenem (96.4% isolated were sensitive). Conclusion: The pattern of antibiotic resistance varies from place to place, region to region, and country to country. Antimicrobial resistance should be monitored on a regular basis in both the community and hospital settings.


2013 ◽  
Vol 37 (2) ◽  
pp. 79-84
Author(s):  
Afroza Begum ◽  
Habibur Rahman ◽  
MM Hossain ◽  
Golam Muinuddin ◽  
Ranjit Ranjan Roy ◽  
...  

Background: Vesicoureteric reflux is the most common urinary tract anomaly affecting the children which predisposes to higher rates of urinary tract infection and renal scarring than those without VUR. Objective: To find out the associations of VUR in children presented with UTI. Methodology: This cross sectional study was conducted in 36 children aged 1 month to 16 years who were admitted due to UTI in the Pediatric Nephrology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from July 2009 to June 2010. UTI were evaluated by urinalysis, culture and sensitivity test, ultrasonography of the urinary system with post-voidal residue and micturating cystourethrogram subsequently. Results: This study revealed that UTI were most frequent in boys (P<0.001). Maximum number 19(52.7%) of UTI cases were detected between 12 months -60 months age group of children. Highest number of bilateral hydronephrosis 7(71.43%) and VUR 12(63.15%) were also detected in the were detected in 2-23 months age group of children. Maximum number of 22/38 kidneys (57.90%) with refluxing units were detected between 12 months to 60 months (1-5 years) age group and out of this 16(72.72%) units are of severe grades. Conclusion: Children presented with UTI along with features of obstructive- uropathy must be investigated early and carefully for VUR to prevent recurrent UTI and renal damage. DOI: http://dx.doi.org/10.3329/bjch.v37i2.17264 BANGLADESH J CHILD HEALTH 2013; VOL 37 (2) : 79-84


2019 ◽  
Vol 6 (5) ◽  
pp. 1814
Author(s):  
Senthil Kumar A. ◽  
Thannoli Gowthami Gowrinathan

Background: Infections are more common in malnourished children, as result of impaired immunity. Unexplained fever and failure to thrive are the common presenting features of urinary tract infection (UTI) in children. In malnourished children, UTI is mostly asymptomatic and is leading to pyelonephritis and renal scarring. The study was done with the aim to evaluate and find out the prevalence of urinary tract infection in malnourished children between 6 months to 5 year and to find out the causative organism and antibiotic sensitivity pattern.Methods: A total of 180 cases of malnourished children were enrolled and clean catch midstream urine sample was collected for urine culture, according to WHO criteria of malnutrition. Children with urinary tract abnormality were excluded from the study. Renal USG was done in all urine culture positive cases.Results: Total of 174 cases was present after exclusion. Of 174 children, 27 (15.5%) children were having UTI. In this study, 37% of children are asymptomatic. E. coli is the commonest organism causing UTI 16 (59%). Other organism are Klebsiella pneumonia 4 (14.9%), Proteus mirabilis 3 (11.1%), and Pseudomonas 3 (11.1%). The order of antimicrobial sensitivity pattern was amikacin (100%)> ciprofloxacin (81.4%)> cefotaxime (7%). Other common drugs have developed resistance to these organisms.Conclusions: Our observations conclude that malnourished children with fever of unknown origin are at risk of UTI. Hence, urine analysis and culture tests are to be done to all malnutrition cases for assisting to diagnose the bacterial infection and providing the appropriate treatment.


2017 ◽  
Vol 4 (7) ◽  
pp. 2251
Author(s):  
Raj Kumar Mathur ◽  
Kunal Vikram Singh ◽  
Poonam Mathur

Background: Urinary problems are common in female population of India which adversely affect their quality of life. Urinary problems add to chronic suffering of Indian females. The objective of this study was to find etiological correlation of common urinary problems in Indian females.Methods: This is an epidemiological study which includes all adult female patients coming to surgery and gynecology OPDs of M.Y. Hospital, Indore, Madhya Pradesh, India.Results: 58.4% of patients of middle age (31-55) years. Burning micturition was most common urinary complaint (86.2%) followed by lower abdominal pain (51.6%). About 66.8% of females took months or even years to take first consultation after appearance of their symptoms. 63.2% females were suffering from urinary tract infection which was confirmed by urinary culture reports. E. Coli was the most common organism causing urinary tract infection. UTI was closely correlated with urinary tract calculi & low use of sanitary napkins. Only 14.6% females suffered from urinary incontinence (stress, urge, mixed). Incontinence was closely correlated with multiple deliveries. In our study about 88% of women had education level below fifth standard.Conclusions: Urinary problems are common in women of low socioeconomic society with lower education, poor urogenital hygiene and multiple births especially unassisted vaginal deliveries.


2015 ◽  
Vol 53 (4) ◽  
pp. 1282-1285 ◽  
Author(s):  
Joseph B. Cantey ◽  
Claudia Gaviria-Agudelo ◽  
Erin McElvania TeKippe ◽  
Christopher D. Doern

Urinary tract infection (UTI) is one of the most common infections in children. Urine culture remains the gold standard for diagnosis, but the utility of urine Gram stain relative to urinalysis (UA) is unclear. We reviewed 312 pediatric patients with suspected UTI who had urine culture, UA, and urine Gram stain performed from a single urine specimen. UA was considered positive if ≥10 leukocytes per oil immersion field were seen or if either nitrates or leukocyte esterase testing was positive. Urine Gram stain was considered positive if any organisms were seen. Sensitivity, specificity, and positive and negative predictive values were calculated using urine culture as the gold standard. Thirty-seven (12%) patients had a culture-proven UTI. Compared to urine Gram stain, UA had equal sensitivity (97.3% versus 97.5%) and higher specificity (85% versus 74%). Empirical therapy was prescribed before the Gram stain result was known in 40 (49%) patients and after in 42 (51%) patients. The antibiotics chosen did not differ between the two groups (P= 0.81), nor did they differ for patients with Gram-negative rods on urine Gram stain compared to those with Gram-positive cocci (P= 0.67). From these data, we conclude that UA has excellent negative predictive value that is not enhanced by urine Gram stain and that antibiotic selection did not vary based on the urine Gram stain result. In conclusion, the clinical utility of urine Gram stain does not warrant the time or cost it requires.


Author(s):  
Akhilesh Kumar ◽  
Rajiv Kumar ◽  
Manju Gari ◽  
Uma Shanker P. Keshri ◽  
Sumit K. Mahato ◽  
...  

Background: Urinary tract infection (UTI) is one of the common infections encountered by the clinicians. Though a good number of antimicrobial agents are available, still UTIs have become difficult to treat due to development of resistance by the uropathogens. So, regional data regarding the common uropathogens and their sensitivity pattern is required to guide the clinicians to start empirical therapy while managing UTIs. The purpose of the study was to identify different species of microorganisms, along with their antimicrobial susceptibility pattern, causing urinary tract infection in outpatient and indoor patients at RIMS, Ranchi, Jharkhand.Methods: Observational study was conducted using urine culture and sensitivity reports collected retrospectively from records maintained in the department of Microbiology over a period from July 2016 to Feb 2017 in tertiary care hospital.Results: UTI was more common in females (57.74%) than in males (42.26%). Among the uropathogens isolated Escherichia coli (37.41%) was found to be the predominant organism followed by Klebsiella species (32.79%), Pseudomonas species (25.86%), and gram-positive bacteria Staphylococcus aureus accounted (3.92%) of total cases. The most common isolates were E. coli showed high sensitivity to amikacin (79.24%), followed by levofloxacin (77.21%) and gentamycin (62.26%). It was found to be resistant to norfloxacin (86%), nalidixic acid (86.76%) and cefotaxime (69.88%).Conclusions: Though various microorganisms are responsible for UTI. Escherichia coli species is the most common organism. Antimicrobial resistance has already emerged against many antibiotics, making empirical treatment of these infections challenging.


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