Clinical, Epidemiological and Bacteriological Profile of Culture Positive Urinary Tract Infections in Febrile Children – A Cross Sectional Study

BACKGROUND Urinary tract infections (UTI) constitute a common cause of morbidity in infants and children. When associated with abnormalities of urinary tract, they may lead to long-term complications including renal scarring, loss of function and hypertension. Most urinary tract infections remain undiagnosed if investigations are not routinely performed to detect them. Prompt detection and treatment of urinary tract infections and any complicating factors are important. The objective of the study is to know the clinical, epidemiological and bacteriological profile (i.e. clinical signs and symptoms, age, sex, family history, associated urinary tract abnormalities, & causative organisms) of urinary tract infections in febrile children with culture positive urinary tract infection. METHODS This descriptive, cross sectional observational study was conducted at outpatient clinics of our “child health clinics” between May 2016 and April 2017 (one year). All children aged 0 to 12 years with culture positive urinary tract infections were included in this study to evaluate the clinical, epidemiological and bacteriological profile. RESULTS A total of 69 children with culture positive urinary tract infections were included in this study. Out of 69 children included in this study, 36 (52.2 %) were females and 33 (47.8 %) were males. Overall female preponderance was seen and the M: F ratio was 0.9:1. But during first year of life in our study group we had more boys (10, 14.49 %) affected with urinary tract infection than girls. 49.3 % of urinary tract infections in the present study belonged to lower socio-economic status. Most common organism causing urinary tract infection in our group was E. coli (56.5 %). Fever (100 %), anorexia or refusal of feeds (52.2 %), dysuria (46.4 %), vomiting (46.4 %) and abdominal pain (39.1 %) were the predominant clinical manifestations observed in our study. CONCLUSIONS Urinary tract infection is a common medical problem in children and it should be considered as a potential cause of fever in children. As febrile children with urinary tract infection usually present with non-specific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. KEYWORDS Urinary Tract Infections (UTI), Febrile Children, Bacteriological Profile, Urine Culture

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UJI DIAGNOSTIK UJI DIAGNOSTIK PEMERIKSAAN NITRIT DENGAN KULTUR URIN PADA SUSPEK INFEKSI SALURAN KEMIH

Klinikal Sains : Jurnal Analis Kesehatan ◽

10.36341/klinikal_sains.v9i2.2099 ◽

2021 ◽

Vol 9 (2) ◽

pp. 131-137

Author(s):

Putra Rahmadea Utami

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Culture ◽

Kidney Tissue ◽

High Specificity ◽

Cross Sectional ◽

Negative Results ◽

Tract Infections

Urinary tract infection (UTI) is the second largest infection after respiratory infection and can cause sepsis. Urinary tract infections occur due to the entry of microorganisms in the urinary tract. The urinary tract that is usually infected is the urethra (urethritis), bladder (cystisis), ureter (ureteristis), kidney tissue (pyelonephritis). This study aims to determine the sensitivity and specificity of the diagnostic test of nitrite examination with urine culture in suspected urinary tract infections. The method of this study is a descriptive-analytical study with a cross-sectional retrospective approach, conducted in the STIKes field laboratory with the population studied in this study were all patients diagnosed with urinary tract infection with a sample size of 50 samples. The results of this study showed positive nitrite results as many as 17 people, 34% percentage, and negative nitrite results as many as 33 people with a percentage of 66% and on urine culture examination obtained positive results as many as 17 people with a percentage of 34%, which results in growth of bacterial colonies on cultures> 100,000 CFU / mL and negative results of 33 people with a percentage of 66%. Sensitivity Results 82%, Specificity 90.9%. The conclusion of this study is the value of sensitivity, high specificity so that the nitrite test with urine culture can be applied to help diagnose UTI.

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URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.3.16 ◽

2018 ◽

pp. 100-108

Author(s):

Dinh Khanh Le ◽

Dinh Dam Le ◽

Khoa Hung Nguyen ◽

Xuan My Nguyen ◽

Minh Nhat Vo ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Culture ◽

Clinical Manifestations ◽

University Hospital ◽

E Coli ◽

Positive Urine ◽

Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

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The Prevalence of Bacterial Pathogens associated with Urinary Tract Infection (UTI) among Patients attending Kam Medical Consult Clinic, Uganda.

10.51168/sjhrafrica.v2i6.35 ◽

2021 ◽

Author(s):

◽

Gerald Turyatunga

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Bacterial Pathogens ◽

Clinical Signs ◽

Cross Sectional Study ◽

Cross Sectional ◽

Etiological Agents ◽

Tract Infections

Background: A urinary tract infection (UTIs) is a common type of infection caused by bacteria that travel up the urethra to the bladder. Globally, it is reported that 150 million people are diagnosed with a UTI annually, costing the world economy over 6 million US dollars in treatment and work loss. Studies conducted in the in-patients pediatric ward of Muhimbili Hospital in Tanzania and Mulago National Referral Hospital in Uganda between five to ten years reported the prevalence of UTI to be 16.8% and 14.6% respectively. On average at Kam Medical Consult Clinic, patients who turn up in the laboratory are about 20%, and 50% of patients present with recurring UTIs clinically. Therefore, there is a need to establish and investigate the prevalence of bacterial pathogens associated with UTI and multiple pathogens that are not known. Methodology: The cross-sectional study was carried out at Kam medical consult clinic (KMCC) located in Kafeero zone Mulago II Kawempe division. The study population was adults and children presenting with symptoms of urinary tract infection. 120 Midstream urine Samples were collected from patients presenting clinical signs of UTI. The diagnosis was done through macroscopy dry chemistry, microscopy, and culture. Results Among the sampled population, 33% of males had urinary tract infections while 67% of females had urinary tract infections. 88.5% were outpatients while 11.5 % were in-patients The overall prevalence of UTI among patients was 63.3% with children aged (1-10) having a prevalence of 5.8 %. Conclusion and recommendation: E.coli is an etiological agent causing UTIs in male and female patients presenting UTI at Kam Medical Consult Clinic. Other etiological agents included Klebsiella, Coliform, Enterococcus species, staphylococcus aureus, pseudomonas species, and candida species. There is a need to monitor the profile of etiological bacteria of UTI through culture and sensitivity regularly.

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Association between the frequency of disposable diaper changing and urinary tract infection in children

Paediatrica Indonesiana ◽

10.14238/pi53.2.2013.70-5 ◽

2013 ◽

Vol 53 (2) ◽

pp. 70

Author(s):

Meirina Daulay ◽

Rosmayanti Siregar ◽

Oke Rina Ramayani ◽

Supriatmo Supriatmo ◽

Rafita Ramayati ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urine Culture ◽

Bacterial Count ◽

Cross Sectional Study ◽

Cross Sectional ◽

Disposable Diaper ◽

Disposable Diapers ◽

Tract Infections

Background Urinary tract infection (UTI) is the most commoncause of fever in children. Less frequent disposable diaper changingis thought to be a cause ofUTI in children. While wearing a diapei;the perinea! area becomes damp with urine allowing bacteria tomigrate from the anus to the external urethral orifice.Objective To assess for an association between the frequencyof disposable diaper changing and urinary tract infections inchildren.Methods This cross-sectional study was conducted in thechildren's outpatient clinic of Haji Adam Malik Hospital fromApril to June 2010. Urine culture was performed in children withsuspected UTI who wore disposable diapers every day. Subjects'ages ranged from 2 months to 2 years 6 months, with samplesmatched and collected by consecutive sampling. Diagnosis ofUTIwas based on urine cultures with bacterial count 2:: 105/mL. Eightychildren were followed in this study and divided into two groups:positive (n=40) and negative (n=40) urine cultures. Chi squaretest was use d to analyze the association between the frequency ofdaily disposable diapers changing during a one week period andthe urine culture results.Results The frequency of daily disposable diapers changing in80 subjects was as follows: < 4 times (22.5%), 4-5 times (40%),and 2::6 times (37.5%) . The frequency of daily disposable diaperchanging in children with positive urine culture was as fo llows:< 4 times (1 8 out of 40), 4-5 times (22 out of 40), and 2::6 times(O out of 40); (P < 0.0001). The most common bacterial speciesfound in urine cultures was Escherichia coli.Conclusion Lower frequency of daily disposable diaper changingis significantly associated with higher UTI incidence in children.

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Prevalence of E. Coli in Urinary Tract Infection of Children Aged 1-15 Years in A Medical College of Eastern Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.4796 ◽

2020 ◽

Vol 58 (221) ◽

Author(s):

Arun Giri ◽

Raju Kafle ◽

Ganesh Kumar` Singh ◽

Niraj Niraula

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Cross Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Presenting Symptoms ◽

Tract Infections

Introduction: Urinary tract infection is one of the commonest causes of childhood morbidity. Earlydiagnosis and appropriate choice of antimicrobials is essential. Hence, this study aims to identify theprevalence of Escherichia coli in childhood urinary tract infections. Methods: This was a hospital based descriptive cross-sectional study conducted in Nobel MedicalCollege, Biratnagar over a period of one year. A total of 163 cases aged 1-15 years were included andclinical profile, laboratory reports including bacterial isolates in urine cultures and their sensitivitypatterns were documented. Results: The prevalence of Escherichia coli is 45 (53.57%) C.I. Escherichia coli was the most commonorganism isolated in bacterial cultures followed by Klebsiella 12 (14.29%), Enterococcus 10 (11.90%).Urinary tract infection was common among females with male: female ratio of 1:2.3. Fever 152(93.2%) and abdominal pain 113 (69.3%) were the most common presenting symptoms. Escherichiacoli was found most sensitive to Nitrofurantoin 43 (95.5%) followed by Ciprofloxacin 41 (91.1%) andAmikacin 40 (88.8%). Conclusions: Urinary tract infections in childhood require prompt attention and treatment to preventsignificant morbidity and mortality. From this study it can be concluded that Escherichia coli is oneof the most common isolates in urine culture and Aminoglycosides and Fluoroquinolones can beaccepted as empirical treatment regimens for childhood Urinary tract infections.

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Undiscovered Urinary Tract Infections

PEDIATRICS ◽

10.1542/peds.39.6.946a ◽

1967 ◽

Vol 39 (6) ◽

pp. 946-947

Author(s):

MELVYN H. WOLK

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Signs And Symptoms ◽

Infants And Children ◽

Tract Infections ◽

In Infants And Children

The occurrence of urinary tract infections in children has become an increasing problem. Pediatricians, especially those experiencing the "unhappy pediatric syndrome," should delight in investigating the manifold signs and symptoms with which these children may present. We have been taught that urologic symptoms, such as dysuria and frequency, may indicate an underlying urinary tract infection. However we must look further, for signs rather than symptoms in infants and children, for they may not be the best historians.

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Letter to the Editor

PEDIATRICS ◽

10.1542/peds.53.2.289b ◽

1974 ◽

Vol 53 (2) ◽

pp. 289-289

Author(s):

Thomas F. Dolan ◽

Alan Meyers

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Culture ◽

Family Practitioners ◽

Letter To The Editor ◽

Routine Basis ◽

Tract Infections

We agree that follow-up urine culture should be obtained after the diagnosis of a urinary tract infection is made. The frequency with which such cultures are obtained is, however, debatable. Our questionnaire did not include this aspect of management. Since 59% of family practitioners and 45% of pediatricians diagnosed urinary tract infections without benefit of culture on a routine basis, it would seem likely that follow-up urine cultures are not performed with regularity. We would join with Dr. Browning in urging careful follow-up and evaluation for children with documented urinary tract infections.

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Serratia Fonticola microbe presented as a community-acquired urinary tract infection (UTI): a case report

Journal of Ideas in Health ◽

10.47108/jidhealth.vol3.iss3.68 ◽

2020 ◽

Vol 3 (3) ◽

pp. 226-227

Author(s):

Atif Abdulhamid Katib ◽

Omar Shaikhomar ◽

Mazen Dajam ◽

Laila Alqurashi

Keyword(s):

Urinary Tract Infection ◽

New Species ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Culture ◽

Treatment Options ◽

Case Series ◽

Skin Lesions ◽

Tract Infections

Background: The case we are presenting is about one of the rare pathogens, Serratia Fonticola (SF) that may cause urinary tract infection. Case Presentation: A 58 years-old female presented with dysuria, suprapubic pain, frequency of micturition, and change in urine color. The patient was afebrile on physical examination; however, the urine culture was positive to SF as the sole isolate. The patient received levofloxacin tables (750 mg) once a day for 5 days along with supportive instructions to improve hygiene. On follow-up, she was free of symptoms and the repeated urine culture was negative. References Geerlings SE. Clinical presentations and epidemiology of urinary tract infections. Microbiol. Spectr. 4, 2016. https://doi.org/10.1128/9781555817404.ch2 Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269-84. https://doi.org/10.1038/nrmicro3432 Gavini F, Ferragut C, Izard D, Trinel PA, Leclerc H, Lefebvre B, Mossel DA. Serratia fonticola, a new species from water. International Journal of Systematic and Evolutionary Microbiology. 1979;29(2):92-101. https://doi.org/10.1099/00207713-29-2-92 Aljorayid A, Viau R, Castellino L, Jump RL. Serratia fonticola, pathogen or bystander? A case series and review of the literature. IDCases. 2016 May 24; 5:6-8. https://doi.org/10.1016/j.idcr.2016.05.003 Müller HE. Isolation of Serratia fonticola from birds. Zentralblatt Bakteriol Mikrobiol Und Hyg - Abt 1 Orig A 1986; 261:212–8. https://doi.org/10.1016/s0176-6724(86)80038-4 Garcia ME, Lanzarot P, Costas E, Lopez Rodas V, Marín M, Blanco JL. Isolation of Serratia fonticola from skin lesions in a Nile Crocodile (Crocodylus niloticus) with an associated septicaemia. Vet J. 2008 May;176(2):254-6. https://doi.org/10.1016/j.tvjl.2007.02.025. Bollet C, Gainnier M, Sainty JM, Orhesser P, De Micco P. Serratia Fonticola isolated from a leg abscess. J Clin Microbiol 1991; 29:834–5. https://doi.org/10.1128/JCM.29.4.834-835.1991 Farmer JJ 3rd, Davis BR, Hickman-Brenner FW, McWhorter A, Huntley-Carter GP, Asbury MA, Riddle C, Wathen-Grady HG, Elias C, Fanning GR, et al. Biochemical identification of new species and biogroups of Enterobacteriaceae isolated from clinical specimens. J Clin Microbiol. 1985 Jan;21(1):46-76. https://doi.org/10.1128/JCM.21.1.46-76.1985 Stock I, Burak S, Sherwood KJ, Gruger T, Wiedemann B. Natural antimicrobial susceptibilities of strains of 'unusual' Serratia species: S. ficaria, S. fonticola, S. odorifera, S. plymuthica and S. rubidaea. J Antimicrob Chemother. 2003;51(4):865-85. https://doi.org/10.1093/jac/dkg156. Gorret J, Chevalier J, Gaschet A, Fraisse B, Violas P, Chapuis M, Anne JG. Childhood delayed septic arthritis of the knee caused by Serratia fonticola. Knee 2009; 16 (6):512–4. https://doi.org/10.1016/j.knee.2009.02.008 Hai PD, Hoa LTV, Tot NH, Phuong LL, Quang VV, Thuyet BT, Son PN. First report of biliary tract infection caused by multidrug-resistant Serratia fonticola. New Microbes New Infect. 2020; 36:100692. https://doi.org/10.1016/j.nmni.2020.100692 Conclusion: This case can be considered globally the third that diagnosed in the urine culture of the asymptomatic patient.

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P0285A COMPARISON OF URINE MICROSCOPY AND CULTURE IN HIV-INFECTED AND NON HIV-INFECTED INDIVIDUALS IN THE ANTI-RETROVIRAL ERA

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0285 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

EIY Madela ◽

Alain Assounga

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Culture ◽

Hiv Positive ◽

Common Causes ◽

Tract Infections ◽

Hiv Negative

Abstract Background and Aims Urinary tract infection is among the most common causes of sepsis presenting in hospitals. The aim was to collect data to enable empirical treatment of urinary tract infections in HIV negative and positive nephrology patients while waiting for urine culture results in order to reduce hospital stay. Our aim is also to assess incidence and antimicrobial susceptibility of urinary tract infections in HIV negative and positive patients. Method A retrospective chart review of nephrology patients admitted from January to December 2014 in Nephrology ward and the first consecutive 200 outpatients seen in Nephrology clinic in 2014 at Inkosi Albert Luthuli Central Hospital was conducted. Information was gathered with the use of a data collection sheet and urinary tract infection was based on urine culture results. All data was analysed using Statistical Package for Social Sciences version 23. Percentages of basic characteristics were calculated between groups. Logistic regression analysis was used to identify factors associated with positive urine culture. Results There were 654 patients in the study, 514 (79%) were HIV negative and 139 (21%) were HIV positive. The incidence of UTI in nephrology patients was 9%, 10.1% in inpatients and 6.5% in outpatients. 22% were HIV positive (p value 0.883, 95% CI 0.550-2.003). 19% had Diabetes mellitus, 15% had Systemic Lupus Erythematosus and 5% were post renal transplant patients. Escherichia coli and Klebsiella pneumonia were the common causes of urinary tract infection at 40.7% and 15.3% respectively with 22% cases on extended beta lactam resistance. Conclusion There was no statistically significant difference on the incidence and anti-microbial isolates between HIV infected and HIV negative nephrology patients with urinary tract infection. Hence, empirical treatment for UTI should remain the same in the 2 groups. Escherichia coli and Klebsiella pneumoniae were the most commonly cultured organisms in both groups. There is microbial resistance to commonly used antibiotics. Constant assessment of anti-microbial sensitivity of urinary tract infections is of paramount importance.

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P009: Quality improvement and implementation of urine culture follow up process

CJEM ◽

10.1017/cem.2020.217 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S67-S68

Author(s):

N. Walji ◽

A. Greer ◽

M. Hewitt ◽

M. BinKharfi

Keyword(s):

Urinary Tract Infection ◽

Quality Improvement ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Chart Review ◽

Urine Culture ◽

Urinary Culture ◽

Tract Infections

Background: The diagnosis of urinary tract infection (UTI) is made based on symptoms, urinalysis and urine culture. While simple urinary tract infections do not require routine culture, the Infectious Disease Society of America (IDSA) Guidelines state that complicated urinary tract infections should have urine cultures performed to determine which antibiotics are effective, as there is a higher risk of infection with resistant organisms. We hypothesized that the rate of urine cultures sent for complicated UTI is less than is recommended by the literature. Aim Statement: We aimed to implement a follow-up reporting system for Urinary Culture in patients diagnosed with complicated UTIs and raise our Urinary Culture rates in this population to 80% by June 2019. Measures & Design: We performed a single-center chart review using Emergency Department (ED) charts of non-admitted patients. They were audited daily for two weeks to obtain a sample of patients who had a discharge diagnosis of urinary tract infection, pyelonephritis or cystitis. Charts capturing these diagnoses were assessed to see if a culture was clinically indicated and if it was ordered. Charts were screened for the presence of any of the following criteria indicating complicated UTI: known structural or functional abnormality of the urinary tract, genitourinary obstruction, pregnancy, immunosuppression, diabetes, indwelling or intermittent catheter use, fever, male patient, clinical pyelonephritis, antimicrobial failure, or transfer from a nursing home. Data was then compiled to determine culture rates in complicated and uncomplicated UTIs. This prevalence rate established the baseline performance in the ED which was used to inform the quality improvement project. Evaluation/Results: Over a two week period, 26 patients were discharged from the ED with a diagnosis of UTI, with 17 of these patients meeting criteria for complicated UTI. Only 6 of 17 complicated UTIs were sent for urine culture, therefore our pre-implementation culture rate was 35%. After initial data collection, a follow-up system was designed ensuring that urine culture and sensitivities results would be compiled and reviewed daily at Hamilton Health Sciences. This system was created with input from key stakeholders including department chiefs, core lab services, ED physicians and business clerks. A discrepancy form was created for documentation of culture result recognition and any required patient follow up ie. antibiotic change. In October 2019, the system had been implemented for a month, after which another chart review was completed. 27 cases were captured, 18 of which were complicated. The complicated culture rate had increased significantly from 35% to 72%. Discussion/Impact: In the ED, ordering of cultures for patients being discharged, regardless of type, is commonly associated with concern of result follow up, which may take up to 72 hours. This discrepancy system was implemented to ensure that all urine cultures ordered had appropriate follow up, thus supporting physicians in ordering cultures when indicated. The significant improvement in culture rate from 35% to 72% is balanced by one single culture of all 9 simple UTIs (11%). In PDSA cycle 2, we hope to increase rates to 90% by improving current challenges with the system.

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