Urinary Tract Infection Profile in Pediatric Patients: A Clinicobacteriological and Radiological Analysis

Abstract

This cross-sectional study was conducted at a tertiary center in Odisha, Eastern India, to identify the profile of urinary tract infections in children (UTI), pathogenic bacteria, and monitoring of vesicoureteral reflux (VUR) and scarring of renal dysfunction in these patients.The study involved a total of 524 pediatric patients aged ≤ 13 years who were suspected of having urinary tract infections. Urine samples were collected to isolate uropathogens and antibiotic susceptibility testing was carried out according to guidelines from the Institute for Clinical and Laboratory Standards (CLSI). 32 children with detected UTI cultures underwent microtouringcysto-urethrography (MCU) and dimercaptosuccinic acid (DMSA) for 69 children.Of the 524 children, 186 (35.4%) had a proven BMI culture because 105 (56.4%) were infants, 50 (27.4%) were between the ages of 1 and 5 years, 30 (16.12%) were between 5 -13 years and 129 (69.35%) male. Posterior urethral valve (PUV) was found in three patients, hydronephrosis in 18, VUR in 18 and renal scarring in 33. In men> 1 year, both VUR and renal scarring were more common. There was a significant association (P = 0.0054) with the combined sensitivity and specificity of this study, 83% and 90%, respectively, of the MCU and DMSA scans for VUR detection. Escherichia coli is the most common isolated pathogen sensitive to nitrofurantoin, followed by cefoperazonesulbactam, aminoglycosides, and meropenem.Our results suggest that urinary tract infections vary according to age and sex and a full evaluation is required in boys under one year of age with urinary tract infections. This study also highlighted the better in vitro efficacy of aminoglycosides, cefoperazonesulbactam and nitrofurantoin compared to meropenem on Gram-negative uropathogens.