English

Abstract

BACKGROUND: Urinary Tract Infection (UTI) is among the most common serious bacterial infections in infants and children, and is frequently missed, probably because of its non- specific presentation. The knowledge of etiology and antibiotic sensitivity and resistance pattern of the organisms causing urinary tract infection is essential. OBJECTIVES: To record the common clinical presentation and risk factors for UTI in children. The distribution of bacterial strains isolated from these patients and their sensitivity and resistance pattern were also studied. MATERIALS AND METHODS: An observational study was conducted in Department of Pediatrics, Raja Rajeswari Medical College, Bangalore, a tertiary care centre, from August to December, 2013. Patients who had UTI confirmed by positive urine culture reports were included in the study. Statistical analysis was done using the SPSS version 17. RESULTS: 82 children had UTI with positive urine culture reports. Maximum number of cases was seen in the age group 1-5 years (51.2%), where males were 31% and females were 69%. Fever was the commonest presenting single symptom and the commonest organisms isolated in urine were Escherichia coli (73.2%), Enterococcus (8.5%) and Klebsiella (4.8%). History of incomplete course of antibiotic (12.1%) and posterior urethral valve (3.7%) were the major risk factors for UTI. Imipenem (58.5%), Amikacin (57.3%) and Gentamicin (52.4%) were the drugs with highest sensitivity to the organisms cultured. Furazolidine, Tobramycin, Metronidazole, Pefloxacin and Cefuroxime were found the most resistant drugs as 97.5% patients were found resistant against each one of them. The other most resistant drug was Erythromycin (96.3%) followed by Amoxicillin (90.2%). CONCLUSION: Overall, females have a higher risk of UTI. Clinical presentation plays a minor role in establishing diagnosis in UTI in children. E. coli is the most widely prevalent organism causing UTI in children. Imipenam, Amikacin and Gentamicin were the drugs with highest sensitivity and Furazolidine, Tobramycin, Metronidazole, Pefloxacin, Cefuroxime, Erythromycin and Amoxicillin were found to be the most resistant drugs. A strong decision has to be established regarding the antibiotic policies for UTI and stringent measures have to be taken to ensure the effectiveness of the same.