Etiologies of Urinary Tract Infections in Children Considering Differences in Gender and Type of Infection

Abstract

Introduction: Urinary tract infection is a common health problem in children. Gram negative entericbacteria, mainly E –coli, are responsible uropathogens. We aimed to define the main etiologies of urinary tract infection in children considering gender and type of infection (febrile versus afebrile).Materials and Methods: We assessed the infections etiology of 648 episodes. Type of infection and etiology were compared between genders. Also, for every uropathogen, a comparison was done between febrile and afebrile infections. Chi square was used for data analysis and P values ≤0.05 were considered as a significant difference.Results: The majority of the infections by Proteus and Enterococcus species were febrile, in contrast to Citrobacter infections which were mostly afebrile. E-coli infections were significantly more prevalent in girls (P=0.0001). Proteus and Kelebsiella infections were more common in boys (P=0.115 and 0.154 respectively), whereas all Enterobacter infections were seen in girls (P=0.129). A comparison was done between females and males based on the type of infection. Although febrile infections were more frequent in boys, the difference was not statistically significant (P=0.059).Conclusions: E-coli, Kelebsiella, Enterobacter and Citrobacter species (90.5%) were the main uropathogens. Infections caused by E-coli were significantly more prevalent in girls. Proteus and Kelebsiella infections were more common in boys, whereas Enterobacter species were more prevalent in girls. The majority of Proteus and Enterococcus infections (>2/3) presented as pyelonephritis, while the frequency of febrile and afebrile infections was similar for E-coli, Kelebsiella, Enterobacter and Staphylococcus species.Keywords: UTIs; Etiology; Gender; Pyelonephritis; Cystitis.