UTI In Children Research Articles

Patterns of antibiotics sensitivity in culture positive cases of urinary tract infections in children.

Objective: To determine the effective narrow spectrum antibiotics for treatment of UTI in children in order to control the rapidly increasing antibiotic resistance to broad spectrum antibiotics. Study Design: Prospective Clinical study. Setting: Department of Pediatric, Akbar Niazi Teaching Hospital, Bhara Kahu-Pakistan. Period: January 2021 to December 2021. Material & Methods: 361 children with clinical suspicion of UTI Urine samples were collected. Antimicrobial sensitivity test was applied on Samples on which bacterial growth was identified using Clinical Laboratory Standards Institute (CLSI) guidelines. The data was analyzed using SPSS version 25. Results: Total 361 patients were enrolled in the study according to inclusion criteria, out of which, 30 (8.3%) were infants (<1 years old), 178 (49.3%) were aged 1 to 5 years and 153 (42.4%) were aged from 5 to 12 years of age. Out of 361 patients, 125 (34.6%) patients were males and 236 (65.4%) were females. Out of 124 patients, whose urine culture was positive, most common pathogen was E. coli that was observed in 92 (25.5%) cases, followed by Klebsialla in 9 (2.5%) and enterococcus in 9 (2.5%) patients, Pseudomonas in 5 (1.4%), Proteus in 4 (1.1%), Mirabilis in 4 (1.1%), Acinobacter in 2 (0.6%), and enterobacter in 2 (0.6%) cases. Spectrum of sensitivity of 17 drugs was studied. The most sensitive drug was Imipenem, (29.9%), followed by Nitrofurantoin, Fosfomycin (25.8%), Amikacin (24.1%), Piperacilin / Tazobactam (22.7%). Conclusion: Thus E. coli was the most common pathogen and the most sensitive drug was Imipenem, followed by Nitrofurantoin, Fosfomycin, Amikacin, and Piperacilin / Tazobactam.

Distribution of Pathogenic Bacterial Causing Urinary Tract Infection and their Sensitivity and Resistant to Antibiotics

Background, Urinary tract infection is one of the common infections in the Libya community. Distribution and susceptibility of causing pathogens change rendering to period and place. UTI are difficult infections, because UTI sick of children, men and pregnant women. The aims of this study are determine the relationship between UTI and gender and age by determine the prevalence of UTI in children, men and women, and observe the more common pathogenic bacteria in UTI. Also, to determine the antimicrobial susceptibility of pathogenic bacteria. Study area, The data of the present article had taken from the recorders of medical laboratory of urine cultures and sensitivity of Zawia's hospital, Zawia city in Libya. Study target, UTI patient's children, women and men. This study detected that bacteria were sensitive to some antibiotics and resist to the others; all types of important pathogenic bacteria were sensitive to both antibiotics Cip and AR. In addition to last antibiotics E. coli, K. pneumonia, P. aeruginosa and S. marcescens were also sensitive to CTX, Amc, SXT, Ipm, and Gm. In opposite to theses pathogenic bacteria, some pathogenic bacteria appearance resistant to some antibiotics as fallow; K. pneumonia, K. oxytoca, E. cloacae, S. marcescens and C. koseri appearance resistant to Amp.

Distribution of Pathogenic Bacterial Causing Urinary Tract Infection and their Sensitivity and Resistant to Antibiotics

Background, Urinary tract infection is one of the common infections in the Libya community. Distribution and susceptibility of causing pathogens change rendering to period and place. UTI are difficult infections, because UTI sick of children, men and pregnant women. The aims of this study are determine the relationship between UTI and gender and age by determine the prevalence of UTI in children, men and women, and observe the more common pathogenic bacteria in UTI. Also, to determine the antimicrobial susceptibility of pathogenic bacteria. Study area, The data of the present article had taken from the recorders of medical laboratory of urine cultures and sensitivity of Zawia's hospital, Zawia city in Libya. Study target, UTI patient's children, women and men.

Ureteral stent extraction strings in children: Stratifying the risk of post operative urinary tract infection

Ureteral stents facilitate recovery and avoid external drains in pediatric ureteral reconstruction. Extraction strings avoid the need for a secondary cystoscopy and anesthetic. Due to concerns regarding febrile UTIs in children with extraction strings, we retrospectively assessed the relative risk of UTI in children with extraction strings. Our hypothesis was that stents with extraction strings do not increase the risk of UTI after pediatric ureteral reconstruction. Records of all children undergoing pyeloplasty and ureteroureterostomy (UU) from 2014 to 2021 were reviewed. The incidences of UTI, fever, and hospitalization were recorded. 245 patients mean age 6.4 years (163M:82F) underwent pyeloplasty (n=221) or UU (n=24). 42% (n=103) received prophylaxis. Of these, 15% developed UTI versus 5% of those not receiving prophylaxis (p<0.05). 42 females had prior history of UTI, compared to 20 males (p<0.05). 49 patients had an extraction string. Stents with extraction strings were removed on average 0.6 months post-op while others underwent cystoscopic removal on average 1.26 months post-op (p<0.05). 9 (18.4%) required hospitalization for febrile UTI while the stent with extraction string was in place, while only 13 (6.6%) of those without extraction string did (p<0.02). Of the 9 children with a febrile UTI in the extraction string group, 6 had history of prior UTI (46.1%), compared to only 3 (8.3%) without a prior UTI (p<0.05). With no prior UTI, there was no difference in UTI risk between those with (3, 8.3%) and without (8, 6.4%) extraction string (p=0.71). Females with prior UTI and extraction string were more likely to develop UTI than those with prior UTI and no extraction string (p=0.01). There were not enough males with history of UTI to analyze alone. There were 5 (10%) stent dislodgements in the extraction string group, 2 required further intervention with cystoscopy or percutaneous drainage. Extraction strings provide the assurance of drainage while avoiding the need for a second general anesthetic procedure. There is not an increased risk of UTI with extraction string in those without prior history of UTI, but we no longer routinely leave extraction strings if there is history of UTI. Children, particularly females, with prior history of UTI have a significantly increased risk of febrile UTIs associated with the use of extraction strings. Prophylaxis does not seem to reduce this risk. Patients with no prior UTI had no higher risk of UTI with extraction string use for pyeloplasty or UU.

Bacterial profile, their antibiotic susceptibility pattern, and associated factors of urinary tract infections in children at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Urinary tract infections (UTIs) are common pediatric infections and contribute to high morbidity and mortality. At present, the antimicrobial resistance emergency has quadrupled worldwide and poses a serious threat to the treatment of patients. However, there have been few studies on UTIs in children in Ethiopia, particularly in the east. This study aimed to assess the bacterial profile of urinary tract infections, their susceptibility to antimicrobial agents, and associated factors in under-five children at Hiwot Fana Specialized University Hospital, eastern Ethiopia. We conducted hospital-based quantitative study on 332 consecutively selected under-five children from March 20 to June 10, 2021. Parents and guardians were interviewed to collect data using a structured questionnaire. Random urine samples were collected aseptically, and standard microbiological techniques were used to identify the bacteria and test for susceptibility to various antibiotics. Data were entered into Epi Info version 7 and exported to Statistical Package for the Social Sciences (SPSS) version 25 for analysis. Data were analyzed using descriptive analysis, bivariate, and multivariable logistic regression analysis. The crude odds ratio (COR) and adjusted odds ratio (AOR) with their respective 95% confidence intervals (CI) were used to determine the significance of the predictors. A p-value at a 95% confidence interval of less than 0.05 was considered statistically significant. The overall prevalence of bacterial urinary tract infections was 80 (24.1%) 95% CI:19.40-29.00%). Most of the bacterial isolates 55 (68.75%) were gram-negative bacteria, predominantly E. coli 23 (28.75%) and K. pneumoniae 10 (12.50%). Being a rural resident (AOR: 4.10, 95%CI: 1.45 11.54), uncircumcised male (AOR: 3.52, 95%CI: 1.33, 9.39), previous history of antibiotic usage (AOR: 7.32, 95%CI: 2.11, 25.37), indwelling catheterization (AOR: 10.35, 95%CI: 3.74, 28.63), previous history of urinary tract infections (AOR: 5.64, 95% CI: 1.36, 23.38), and urinary frequency (AOR: 5.56, 95%CI: 2.03, 15.25) had higher odds of culture positive result. The majority of the isolates have shown high levels of antibiotic resistance. Meropenem, ciprofloxacin, and amoxicillin-clavulanic acid were effective against gram-negative uropathogens, whereas rifampin and ciprofloxacin were the most sensitive drugs for gram-positive isolates. From the tested bacterial isolates, 53/86 (61.6%), 11/86 (11.6%), and 2/86 (2.3%) were found to have multidrug resistance (MDR), extreme drug resistance (XDR), and pan drug resistance (PDR), respectively. About one-fourth of the children were culture-positive for many types of bacterial uropathogens; this is higher compared with most of the previous studies in Africa. Rural dwellers, uncircumcised males, indwelling catheterization, a history of antibiotic use and urinary tract infection, and frequent urination all had a higher risk of bacterial infections. Many isolates were resistant to multiple drugs, primarily beta-lactams. Urinary tract infections as well as the growth and spread of resistant bacterial pathogens should be monitor regularly.

PD37-10 THE TRUE INCIDENCE OF URINARY TRACT INFECTIONS AMONG INFANTS WITH ISOLATED HYDRONEPHROSIS

You have accessJournal of UrologyCME1 Apr 2023PD37-10 THE TRUE INCIDENCE OF URINARY TRACT INFECTIONS AMONG INFANTS WITH ISOLATED HYDRONEPHROSIS Margarita Chancy, Jin K Kim, Michael Chua, Joana Santos, Natasha Brownrigg, Juliane Richter, Tim Van Mieghem, Armando J Lorenzo, and Mandy Rickard Margarita ChancyMargarita Chancy More articles by this author , Jin K KimJin K Kim More articles by this author , Michael ChuaMichael Chua More articles by this author , Joana SantosJoana Santos More articles by this author , Natasha BrownriggNatasha Brownrigg More articles by this author , Juliane RichterJuliane Richter More articles by this author , Tim Van MieghemTim Van Mieghem More articles by this author , Armando J LorenzoArmando J Lorenzo More articles by this author , and Mandy RickardMandy Rickard More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003335.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The rate of UTI in healthy febrile infants is 7%. Isolated hydronephrosis (HN) refers to dilation of the renal pelvis and has been associated with an increased risk of UTI resulting in continuous antibiotic prophylaxis (CAP) use. Our goal was to determine the overall rate of UTI stratified by type, CAP, VUR. METHODS: A HN database from 2015-22 was examined. Included patients were less than 24 m at baseline with isolated HN, and those with other abnormalities were excluded. Captured variables included age, sex, circumcision status, HN severity and VUR. UTI was defined as fever with pyuria and positive culture from catheterized specimens. UTIs were categorized as index (pre-presentation), surveillance (while being followed), and post-procedural (associated with surgery/tests). RESULTS: A total of 689 patients were included. The median age at baseline was 2 m (0-24 m) and follow-up was 23 m (6-195). A total of 52% were prescribed CAP and received it for 6 m (0-53). The overall UTI rate was 9% which developed at 5 months (0-32 m) of age. UTIs were index in 32 (5%), surveillance in 11 (2%) and post-procedural in 20 (3%). After excluding procedural UTIs, the actual rate was 7%. Most patients were male (81%) and 62% were uncircumcised. Uncircumcised males comprised 77%, 64% and 63% of index, surveillance and post-procedural UTI respectively. 96% had isolated HN and 53% had high grade (SFU 3-4) 1% of had concomitant UPJ+UVJ obstruction and 3% were known to have VUR, however only 30% were investigated with VCUG. When comparing surveillance UTI to none, the only significant finding was more VUR in the surveillance group (18%) vs. 2% in the no infection group (p<0.01). UTI characteristics by category can be reviewed in Table 1. Comparisons between surveillance and no UTIs can be reviewed in Table 2. CONCLUSIONS: The overall incidence of UTI in children with isolated HN is low. We demonstrated that the rate of UTI is similar to the general population, generating controversy regarding the necessity of CAP. This presents an opportunity to limit exposure to antibiotics to children with isolated HN. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e991 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Margarita Chancy More articles by this author Jin K Kim More articles by this author Michael Chua More articles by this author Joana Santos More articles by this author Natasha Brownrigg More articles by this author Juliane Richter More articles by this author Tim Van Mieghem More articles by this author Armando J Lorenzo More articles by this author Mandy Rickard More articles by this author Expand All Advertisement PDF downloadLoading ...

Clinical Therapy of UTI in Children Under the Age of Five Varies Widely

Clinical Therapy of UTI in Children Under the Age of Five Varies Widely

Neutrophil extracellular traps in urinary tract infection.

Urinary tract infections (UTI) are common types of bacterial infection in children. UTI treatment is aimed to prevent complications including hypertension, proteinuria, and progression to chronic kidney disease. Activated neutrophils release chromatin-based structures associated with antimicrobial proteins called neutrophil extracellular traps (NETs). We aimed to describe the role of NET-associated markers in children with UTI as well as the role of NETs formation in a mouse model of UTI. Markers of NETs including extracellular DNA (ecDNA), myeloperoxidase (MPO) and cathelicidin were analyzed in children with febrile UTI caused by E. coli (n = 98, aged 0.3-1.3 years) and in healthy controls (n = 50, 0.5-5.2 years). Moreover, an acute experimental model of UTI was performed on PAD4 knock-out mice with diminished NETs formation (n = 18), and on wild-type mice (n = 15). Children with UTI had significantly higher urinary NETs markers including total ecDNA, nuclear DNA and mitochondrial DNA, altogether with MPO and cathelicidin. The concentrations of MPO and cathelicidin positively correlated with ecDNA (r = 0.53, p ≤ 0.001; r = 0.56, p ≤ 0.001, respectively) and the number of leukocytes in the urine (r = 0.29, p ≤ 0.05; r = 0.27, p ≤ 0.05, respectively). Moreover, urinary MPO was positively associated with cathelicidin (r = 0.61, p ≤ 0.001). In the experimental model, bacterial load in the bladder (20-fold) and kidneys (300-fold) was significantly higher in PAD4 knock-out mice than in wild-type mice. Higher urinary NETs makers-ecDNA, MPO and cathelicidin and their correlation with leukocyturia in children with UTI confirmed our hypothesis about the association between NETs and UTI in children. Higher bacterial load in mice with diminished NETs formation suggests that NETs are not only a simple consequence of UTI, but might play a direct role in the prevention of pyelonephritis and other UTI complications.

Frequency of Urinary Tract Infection in Febrile Children without Any Focus on Infection

Background: In newborns and young children, a urinary tract infection is a frequent hidden cause of fever. Children younger than a year old who appear with fever and symptoms of UTI are usually given treatment for something else. Objectives: The objective of this study was to assess the prevalence of UTI in children presenting to a tertiary care hospital between the ages of 1 month and 36 months with nonspecific fever. Duration and study settings: The Children's Hospital Pakistan Institute of Medical Science, SZABMU, Islamabad, was the site of this trial, which ran from Jan 2018 to June 2018. Study design: Descriptive cross sectional Methodology: After a complete medical history and physical examination, a urine sample was taken for testing and culture using a soft tube in younger children and a clean catch approach in older children or those who are cooperative. Urisys 2400 was used to analyse the urine samples. Larger children's urine samples were grown on CLED agar plates (cysteine lactose, electrolyte deficient). Clinitek Siemens, a haematology analyser, was used to determine the number of white blood cells in the blood. The Pakistan Institute of Medical Sciences in Islamabad is home to a state-of-the-art laboratory where tests including leucocyte count, urine DR, and culture were conducted. A pre-designed proforma was used to record the patient's demographic information, medical history, diagnosis, and laboratory results. Results: In this study, 6.47 percent (n=18) of 278 children aged 1 to 36 who presented to a tertiary care hospital with a fever and no other obvious signs of infection were found to have a urinary tract infection. Conclusion: Children arriving to a tertiary care hospital with a fever and no other signs of infection are not likely to have a urinary tract infection. Keywords: UTI in children with diffuse fever and no obvious source of infection.

Prevalence, identification and frequency of uropathogens causing urinary tract infection in children in Ujjain (M.P.)

: Urinary tract infection is one of the most common infectious disease found in all population and has become a major health problem. The urinary tract infection also affects pediatric population especially in the age group of 0-5 years. The aim of this study to find out prevalence of UTI in children, its occurrence in different gender and seasons along with identification of causative agent of UTI in children in Ujjain. The study was carried out in SRL laboratory Ujjain center and total 881 suspected patients urine sample were collected and tested by conventional methods for prevalence of significant bacteriuria. It was seen that 550 samples were positive and out of these, positive case 111 belonged to children of 0-5 years of age. Thus, 20.18% positive cases were of children. The percentage of UTI in female children was high (54.0%) while in male children it was low (45.9%) and high number of cases were recorded in rainy season (39.6%), followed by summer and winter seasons which were (34.2%) and (26.1%) respectively. The six major uropathogens present in urine sample were isolated and identified and among them four were gram negative in which . , . , . , . were gram negative while and . and . were gram positive UTI causing bacteria in children. In our study frequency of . was highest (60.3%) while . was present in very low frequency (3.6%) so the prevention of UTI in children should be done by proper care of children by mothers.

Clinical and Microbiological Characterization of Pediatric Patients with Urinary Tract Infection in a Fourth-Level Hospital in Bogotá, Colombia, over a Period of Four Years

Introduction: Urinary tract infection is one of the most frequent infectious diseases in the pediatric population. There is no updated data available in literature of the pathogens responsible for complicated and uncomplicated UTI in children and their antimicrobial resistance profiles at the San Ignacio University Hospital or in the city of Bogotá. Objective: Carry out a demographic and clinical characterization of pediatric patients with UTI and a microbiological characterization of the resistance pattern of its main etiological agents. Study design: Cross-sectional study including all pediatric patients under 10 years of age with UTI confirmed by urine culture who consulted our institution between January 2014 and December 2017. Redcap was used for the registration of data corresponding to demographic variables, clinical manifestations, isolated microorganisms with their antibiograms, complications, and recurrence rate of UTI. Results: A registry of 675 patients under 10 years of age with urinary tract infection was obtained, with an average age of 23 months and a higher prevalence in females (71%). 15.4% of the patients had an urinary tract malformation, 3.5% had history of previous urological surgery and 21% had constipation as a comorbidity. 98.4% of the UTIs were acquired in the community and the most common isolated agents were Escherichia coli (73.9%), Proteus mirabilis (12.4%) and Klebsiella pneumoniae (4.7%). The most frequent resistance patterns were penicillinase-producing (41.5%) multi-sensitive (32.1%) and cephalosporins resistance (26%). Regarding the treatment established, cephalosporins were used in 92% of the cases; mainly of first generation (61%) and third generation (38%). 23% of the patients had an associated complication.

Commentary to pyeloplasty with ureteral stent placement in children: Do prophylactic antibiotics serve a purpose?

In this article the rate of UTI in children given prophylactic antibiotics after a stented pyeloplasty is compared to those who were stented and did not receive prophylaxis. The authors show through a large multi-center study that prophylactic antibiotics did not decrease stent associated UTI. This paper is timely as clinicians are acutely aware of the need for increased antibiotic stewardship. In addition, by decreasing the use of antibacterial prophylaxis surgeons can positively impact heath care costs.

Infection of the Urinary Tract and its Prevalence Among Children Presenting with Malnutrition

Background: UTIs are a common cause of acute illness in newborns and young children, affecting 8% of girls and 2% of boys by age seven, with a recurrence rate of 10% to 30%. A UTI is a serious condition that can develop into sepsis and other life-threatening consequences in children Objective: To assess the frequency of urinary tract infections in malnourished children. Material and Methods: The study included 241 patients from the Pediatric Department of Children Gajju khan medical collage Swabi. Pakistan. July 7, 2019 – January 7, 2020, All children had urine samples taken by urine bags and catheterization and forwarded to the hospital laboratory to test for UTIs. The same consultant microbiologist with at least five years of expertise supervised all laboratory studies. Results: As per frequencies and percentages for UTIs, 19 (7.88%) patients had UTIs. Conclusion: Given the high frequency of UTIs in children with severe malnutrition, additional research utilizing standardized microbiological approaches is essential. To support the treatment recommendations for UTIs in these children, using urine dipsticks and microscopy in conjunction with urine culture is critical. Keywords: Protein Energy Malnutrition, Bacterial Infection, Urinary Tract Infections.

Effective antimicrobial therapies of urinary tract infection among children in low-income and middle-income countries: protocol for a systematic review and meta-analysis

IntroductionUrinary tract infection (UTI) is a frequently diagnosed infection in women and children. Treatments are often initiated with broad-spectrum antibiotics without performing any culture and sensitivity test. Inappropriate and empirical...

Clinical Utility and Accuracy of UTI Calculator for Estimating the Probability of Urinary Tract Infection in Young Febrile Children

Objective: To investigate the accuracy of the UTI Calculator (UTI Calc) in predicting UTI in children by comparing the results of urine culture sensitivity tests (C/S). Study Design: Cross-sectional/descriptive study Place and Duration: The study was conducted at Urology Ward of Saidu Group of Teaching Hospitals, Swat during the period from 1st June 2020 to 31st December 2020. Methods: A total of eighty five children having ages from 4 to 24-months were presented. Children with fever &gt;38oC were included. Following informed written agreement from the authorities, the demographics of enrolled cases were documented. Efficacy of UTI calculator was assessed in terms of diagnosing urinary tract infection among children. SPSS 21.0 was used to analyze complete data. Results: Among 85 cases, majority were male 50 (58.8%) infants and 35 (41.2%) were females. The mean age of the children was 8.44±7.65 years. Frequency of UTI was found among 9 (10.6%) febrile infants. Among 85 patients clinical UTI was high in 45 (52.9%) cases and by urine examination UTI found among 10 (10.6%) cases. Frequency of sensitivity was 100% and specificity 96%. E. coli was the predominant bacterium in 10 (11.8%) and urine cultures positive in (7.1%). Conclusion: In children, just a few clinical signs and symptoms are helpful in diagnosing or ruling out a urinary tract infection. Clinical prediction rules may be more accurate, but they need be externally verified. Urine collection should not be limited to children who have an unexplained fever or other symptoms that imply a urinary tract infection.

1153. ESBL Producing E. coli Urinary Tract Infections in Children: Is Carbapenem Always Necessary?

BackgroundUrinary tract infections (UTI) are common in children with a prevalence of 5% in infants. UTI are the main reason for beginning antibiotics in children’s hospitals and E. coli is approximate 80% of urinary pathogens. Extended-spectrum beta-lactamases (ESBL) producing E. coli are a common concern in daily practice. Carbapenems, especially ertapenem are the choice for the treatment in some hospitals, but aminoglycosides or trimethoprim and sulfamethoxazole are options for carbapenem saver. The aim of this study was comparing the clinical outputs in ESBL producing E. coli ITU in children treated with ertapenem or amikacin. MethodsWe designed a quasi-experimental study. In 2018 the antimicrobial stewardship program begins the use of amikacin for non-septic UTI for ESBL producing E. coli. Before this recommendation the use of ertapenem was common. We use WHONET 5.6 to identify ESBL producing E. coli UTI between 2016 and 2020. We analyzed the information using R 4.0.3.ResultsWe analyzed 162 clinical records. 89 in ertapenem group, 45 in amikacin group, 23 in other treatments (TMP-SMX, meropenem) and 5 patients that received empirical treatment (Cefazolin) with clinical improvement and ambulatory management. The initial clinical and paraclinical variables was similar between two groups, only meropenem was more frequent in amikacin group as empiric treatment (table 1). Amikacin group received for media 7.4 days of antibiotic therapy (IQR 7-7.5) and ertapenem 8.2 days (IQR 7-10) (p value 0.049). The mortality, PICU requirement, mechanical ventilation and inotropic requirement was similar an both groups (Table 2). In amikacin group the median length of stay was 7.2 days (IQR 4-9) and in ertapenem group was 9 days (IQR 6-10). No significant adverse effects were documented in any group. Table 1. Patient’s characteristics in both groups. Table 2. Patient’s Clinical outcomes in both groups ConclusionThe use of amikacin in ESBL producing E. coli UTI in children have similar clinical outputs that ertapenem. The use of amikacin could decrease de hospitalization time. Disclosures Ivan Felipe Gutiérrez Tobar, n/a, Pfizer and MSD (Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau, Has received support from Pfizer and MSD for participation in congresses and has received conference payments from Pfizer)Pfizer and MSD (Speaker’s Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses)

Risk factors of vesicoureteral reflux and urinary tract infections in children with imperforate anus: A population-based case-control study in Taiwan.

Imperforate anus (IA) is associated with several urological anomalies, including vesicoureteral reflux (VUR), a major contributor to high morbidity in patients with anorectal malformations. This retrospective study was performed to elucidate the risk factors of vesicoureteral reflux (VUR) and UTI in children with IA.We used the National Health Insurance Research Database (NHIRD) to estimate the frequency of congenital anomalies of the kidney and urinary tract (CAKUT) in children with IA. We also investigated the frequencies of VUR, UTI, and CAKUT in children with IA along with the risk factors of VUR.We enrolled 613 children between 2000 and 2008 (367 males and 246 females; 489 low-position IA and 124 high-position IA). High-position IA was associated with a significantly increased risk of VUR compared with low-position IA (OR: 2.68, 95% CI: 1.61, 4.45). In addition, children with IA along with CAKUT, hydronephrosis, or UTI had a higher risk of VUR (OR: 8.57, 95% CI: 3.75, 19.6; OR: 7.65, 95% CI: 4.48, 13.1; and OR: 31.8, 95% CI: 11.5, 88.3, respectively). UTI, as well as chromosomal anomalies, were more frequent in children with high-position IA.Patients with a high-position IA had a greater risk of VUR, particularly those with CAKUT, hydronephrosis, or UTI. Such patients must periodically undergo urinalysis to screen for UTI and early voiding cystourethrogram to rule out VUR and prevent consequent renal damage. Chromosomal analysis is suggested to rule out Down syndrome.

Frequency of Isolation and Antibiotic Susceptibility of Micro-Organisms Causing Urinary Tract Infections in Children

Objective: To determine the frequency of urinary tract infections and the spectrum of microorganisms causing UTI and their antibiotics susceptibility pattern in children age between 1 month and 12 years. Patients and Methods: In this cross-sectional study, 131 patients of suspected UTI, from the department of pediatric medicine were included, from June-2020 to Nov-2020. 5 milliliters of urine sample were collected and sent to the hospital laboratory for determination of UTI. If UTI was confirmed, samples were further processed to determine the pattern of organisms causing UTI and their antibiotic spectrum. Results: Mean age of the patients included in this study was 6.07±256 years. There were 75 (57.25%) male patients, and 56 (42.75%) female patients. Urinary tract infections were diagnosed in 30 (22.90%) patients. E. coli diagnosed in 14 (46.67%) patients. Resistant strains were diagnosed in 3 (10%) patients. Regarding antibiotic sensitivity, 3rd generation cephalosporins and carbapenems were sensitive to many organisms. Conclusion: E. coli is the predominant uropathogen causing UTIs in children. Third generation cephalosporins are optimal initial choice for management of UTI in children. Keywords: urinary tract infections, causating micro-organisms, antibiotic sensitivity

Prevalence of Urinary Tract Infections (UTIs) in Children with Inguinal Hermia Repairs

This case control study was carried out in Baghdad city from 1st of April 2018 to 1 March 2019 included40 studied cases (children with inguinal hernia) and 40 healthy children to evaluate the prevalence of UTIsin children with inguinal hernia repairs. it was known that the children are infected or not with urinarytract infection through clinical examination of the signs that indicate urinary tract infection, as well as alaboratory examination of the urine to detect the presence of bacteria that cause urinary tract infectionin the laboratory. All children under 15 years of age were included in the study who attended pediatricsurgery clinics. Ages over the age of 15 years old, children with complex inguinal hernia such as blocked,irreducible, strangulated hernia and children with recurrent hernia were excluded. All children included inour study included in the study were examined through routine and microscopic examination of urine, urineculture and sensitivity. children with urinary tract infections were treated according to sensitivity culturereports. This case control study included children with inguinal hernia (90% males and 10% females), theirage range was &lt;1 year to 15 year (mean: 9.52±1.3 year), the study also included 40 healthy children (ascontrol group) with the same characteristics of patient. Thestudyrevealedthaturinary tract infection wasobserved in 25% of (10 of 40) of children with inguinal hernia compared with 5% of (2 of 40) of thecontrol group (P&lt;0.001).This study showed that most of children with inguinal hernia were suffered fromabdominal pain, urge to urinate, polyurea , cloudy urine, fever and pyelonephritis. The study found that,50% of children with inguinal hernia who suffered from UTI were due E. coli, S. aureus with rate 40% andKlebsiella spp with rate 10%. The study showed that 80% of E. coli isolates were sensitive to ampicillin,60% to amikacin and 40% to Amoxiclave, while 100% of S. aureus were sensitive to Ceftriaxone and cand75% to Cefotaxime.It was concluded that, there significant positive correlation between UTIs and inguinalhernia repairs in children.

Frequency of Urinary Tract Infection in Children with Diarrhea

Aim: To determine the frequency of UTI in children presented with diarrhea. Study Design: Cross-sectional Place and Duration: Pediatrics department of Alkhidmat Hospital, Peshawar and Sharif Medical and Dental College, Lahore for six months duration from October 2020 to March 2021. Methodology: Total 120 patients of both gender with ages 2 months to 5 years were enrolled in this study. After taking written consent from parents/guardians, detailed demographics including age, sex, residence, severity and complete medical history were examined and recorded. Urine samples were obtained for examination of urine culture. Data was analyzed by SPSS 24.0. Results: There were 78 (65%) males while 42 (35%) patients were females. 58 (48.33%) patients were ages &lt;1 years, 45 (37.5%) had ages between 1 to 3 years and 17 (14.17%) were ages of &gt;3 years. 36 (30%) patients had mild, 50 (41.67%) had moderate and 34 (28.33%) had severe diarrhea. UTI was found in 40 (33.33%) patients. E.coli was the commonest organism found in 28 (70%) patients followed by K. pneumonia in 12 (30%) patients. Conclusion: Frequency of urinary tract infection was high among children with diarrhea. E.coli was the commonest organism associated with UTI. Keywords: Urinary Tract Infection, Diarrhea, Children