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Clinico-microbiological profile of culture positive urinary tract infection in children

Author: 
Saurabh Aggarwal and Bal Mukund

Urinary Tract Infection (UTI) is one of the commonest bacterial infection in children. Male children have less chances than female children and may be associated with renal parenchymal damage leading to long term renal complications. Though children rarely presents with symptoms of UTI, a high index of suspicion is warranted as fever may be only feature in small children. Purpose of this study was to see clinical presentation and outcome of culture positive UTI in children.
Material and Methods: Our study was conducted in a tertiary care service hospital in India. All culture positive UTI were enrolled in the study. All demographic, clinical and investigational data were collected.
Results: A total of 55 culture positive UTI were enrolled in the study period. Female outnumbered the male gender by 1.4:1. The most common age for presentation was in in infant and preschooler (1-4 years) age group. The most common presentations were fever, urinary complaint and diarrhea. Fever was sole presentation in infant in culture positive UTI in comparison with other age group. 40% children were asymptomatic. The most common organism were E coli and proteus.Renal tract anomalies were found in 7% cases and on follow up 3.7% children had abnormality on either DTPA or DMSA scan. Most common empirical antibiotics used was aminoglycosides and mean duration for injectable antibiotics was 4.6 days.
Conclusion: The Culture positive UTI was most common in female and the most common organism were gram negative with good response to empirical antibiotics aminoglycosides. In a febrile infant even without any associated symptom exclusion of UTI is recommended.

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