Sambhu Sankar Patra, B. Maheswar Rao
BACKGROUND Urinary Tract Infection (UTI) is a common bacterial infection in infants and children. The risk of having UTI before age 14 yrs. is approximately 1 to 3% in boys and 3 to 10% in girls. In neonatal period UTI is more common in males and during infancy it is equal in both sexes. The objectives of the study are- to estimate the incidence of UTI in febrile children between 5 to 14 yrs. age group and also to find out the aetiological agents and their antimicrobial sensitivity pattern. MATERIALS AND METHODS All the participants and their parents were interviewed using structured questionnaire for UTI, detailed history. Physical examination with relevant investigations were carried out. Clean catch mid-stream urine collected under aseptic precautions was subjected for microscopic examination and culture. Urine culture samples were transported and processed within an hour in the laboratory. Ultrasonogram of abdomen was done in all the culture positive cases. Study Design- Prospective Observational Study. Participants- All children having febrile illness without localising signs and /or having symptoms and signs of urinary tract infection (UTI) of age group 5 to 14 yrs. RESULTS Out of total 400 febrile patients, males were 184 (46%) and females were 216 (54%). urine culture was positive in 43 cases (10.75%) with a male to female ratio of 1: 2.9. Increased urinary frequency was an important complaint in majority. Pyuria was present in 128 cases (32%). Urine culture showed 37/43 cases (86%) of Escherichia coli (E. Coli), followed by Enterococcus 2/43 cases (4.65%), citrobacter 2/43 cases (4.65%), Klebsiella in 1/43 case (2.3%) and Candida in 1/43 case (2.3%). E. coli was mostly sensitive to Gentamycin, Amikacin followed by nitrofurantoin, Cefixime and least sensitive to Ampicillin. USG abdomen showed some form of abnormality in only 7/43 cases (16.27 %). Phimosis cases were 6.25% (12/184) in total male cases and culture positive was 9% (1/11 cases). CONCLUSION All febrile children of unidentified aetiology should be screened for UTI especially in female children. Our study found the incidence of UTI in febrile children is 10.75 %. Most common uropathogen was E. coli and is sensitive to Gentamycin, Amikacin, nitrofurantoin and Cefixime. Urine culture is an important investigation tool for proper diagnosis of UTI in children.
