Abstract
ObjectivesThe pediatric urinary tract infection (UTI) often remains under-diagnosed or neglected owing to non-specific clinical presentations, patients failing to describe the actual situation and of clinical practice in diagnosis. The study was aimed to determine the etiologies of UTI in children with enhanced quantitative urine culture (EQUC) technique.ResultsOf enrolled 570 pediatric urine samples, the significant growth positivity was higher in EQUC 92 (16.15%) compared to standard urine culture (SUC) 73 (12.80%) technique. 20.6% of the significant isolates as detected with EQUC were missed on the SUC technique. The age group, in range 1–4 years, was more prone to the infection, where E. coli was the commonest pathogen. EQUC detected, probably all isolates, contributing UTI i.e. multidrug-resistant (MDR), extensive drug-resistant (XDR), and extended-spectrum β-lactamase (ESBL) producers, as some of them skipped on the SUC technique. Of total organisms isolated from EQUC, 46% were ESBL producer, 56.5% were MDR, and 1.4% were XDR. However, 40.5% ESBL, 44% MDR but no XDR detected on SUC. Hence a simple modification on conventional culture protocol could be a crucial modification for the detection of etiologies, contributing UTI, and hence to reduce inapt antimicrobial burden.
Highlights
Urinary tract infection is one of the most common infections with a leading cause of morbidity and mortality in children [1]
Since the 1950s, the clinical practice has relied upon standard urine culture (SUC) protocol as a gold standard in detecting etiologies contributing urinary tract infection (UTI); continues to be
A precise diagnosis of the etiologies and its resistivity status against the preferred antibiotics is crucial for successful clinical management and prophylaxis
Summary
Urinary tract infection is one of the most common infections with a leading cause of morbidity and mortality in children [1]. In this age-group, the infection often remains under-diagnosed or neglected owing to nonspecific clinical presentations, patients failing to describe the actual situation, and of conventional clinical practice of diagnosis [2]. Since the 1950s, the clinical practice has relied upon SUC protocol as a gold standard in detecting etiologies contributing UTI; continues to be the documented incidence of the infection ranges from 23.1 to 37.4% in the Nepalese population [4]. A precise diagnosis of the etiologies and its resistivity status against the preferred antibiotics is crucial for successful clinical management and prophylaxis.
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