DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20184425

Study of urinary tract infection in febrile children below 2 years of age

P. L. Prasad, Aditi Gupta, Gaurav Mukhija

Abstract


Background: Urinary Tract Infection (UTI) in age group 0-2 years is of special interest to clinicians and assumes importance as it can lead to pyelonephritis, septicemia or meningitis in newborn and infants which can be fatal. This study is undertaken to calculate the incidence of UTI in febrile children less than 2 years of age and to compare the incidence with afebrile children visiting pediatric OPD and IPD of SRMS IMS.

Methods: Two hundred and two febrile infants and children constituted the case group. A control group, constituted of one hundred and ninety seven, age and sex matched afebrile patients from IPD/OPD. Urine collected was subjected to microscopic and microbiological examination.

Results: There were ten cases of UTI in the study group and none was found in the control group. The overall incidence of UTI in febrile infants and children less than 2 years was 4.95%. Infants and children admitted with diagnosis other than UTI were screened for UTI and it was found in 4.6% of the cases whereas babies admitted without definite focus had an incidence of 5.56% which signifies that UTI should be screened in all febrile infants irrespective of their other etiologies of fever. Maternal illiteracy was found to be statistically significant as 5 out of 10 cases of UTI were associated with illiterate mothers.

Conclusions: In the present study, we found that the screening of the infants for identification of UTI is useful irrespective of the presence of other etiologies thus early initiation of treatment prevents most complications of UTI, so the importance of early diagnosis cannot be overemphasized.


Keywords


Bacteriuria and pyuria, Failure to thrive, Pyelonephritis, Urinary tract infection

Full Text:

PDF

References


Riccabona M. Urinary tract infections in children. Current Opinion Urol. 2003 Jan 1;13(1):59-62.

Morton RE, Lawande R. I. The diagnosis of urinary tract infection: comparison of urine culture from suprapubic aspiration and midstream collection in a children's out-patient department in Nigeria. Ann Tropical Paediatr. 1982 Sep 1;2(3):109-12.

Morton RE, Lawande R. II. Frequency and clinical features of urinary tract infection in paediatric out-patients in Nigeria. Ann Tropical Paediatr. 1982 Sep 1;2(3):113-7.

Banapurmath C, Jayamony S. Prevalence of urinary tract infection in severely malnourished preschool children. Indian Pediatr. 1994;31(6): 679-82.

Bagga A, Tripathi P, Jatana V, Hari P, Kapil A, Srivastava RN, et al. Bacteriuria and urinary tract infections in malnourished children. Pediatr Nephrol. 2003;18(4):366-70.

Urinary Tract Infection in children. Diagnosis, treatment and long-term management. www.nice.org.uk 2007. Available at https://www.nice.org.uk/guidance/cg54/evidence/full-guideline-196566877. 2007; 178.

Elder JS. Urinary Tract Infections. In Nelson Textbook of Pediatrics. Kliegman, Stanton, Geme St, Schor 20th ed. John F. Kennedy Blvd. Philadelphia 2016:2556-62.

Revised Statement on Management of Urinary Tract Infections. www.indianpediatrics.net. Indian Pediatr 2011; 48:709-711. Available at http://www.indianpediatrics.net/sep2011/sep-709-717.

Srivaths PR. Prevalence of urinary tract infection in febrile infants and children below 2 years of age. New Delhi, India: University of Delhi. 1994.

Dharnidharka VR, Kandoth PW. Prevalence of bacteriuria in febrile infants. Indian Pediatr. 1993 Aug;30(8):987-90.

Srivaths PR, Rath B, Krishan Prakash S, Talukdar B. Usefulness of screening febrile infants for urinary tract infection. Indian Pediat. 1996 Mar;33:218-9.

Bauchner H, Philipp BA, Dashefsky BA, Klein JO. Prevalence of bacteriuria in febrile children. Pediatr Infect Dis J. 1987 Mar;6(3):239-42.

Dickinson JA. Incidence and outcome of symptomatic urinary tract infection in children. Br Med J. 1979 May 19;1(6174):1330-2.

Krober MS, Bass JW, Powell JM, Smith FR, Seto DS. Bacterial and viral pathogens causing fever in infants less than 3 months old. Am J Dis Children. 1985 Sep 1;139(9):889-92.

Crain EF, Gershel JC. Urinary tract infections in febrile infants younger than 8 weeks of age. Pediatr. 1990 Sep 1;86(3):363-7.

Dayan PS, Bennett J, Best R, Bregstein JS, Levine D, Novick MK, et al. Test characteristics of the urine Gram stain in infants ≤60 days of age with fever. Pediatr Emergency Care. 2002 Feb 1;18(1):12-4.

Hoberman A, Chao HP, Keller DM, Hickey R, Davis HW, Ellis D. Prevalence of urinary tract infection in febrile infants. J Pediatr. 1993 Jul 1;123(1):17-23.

Shaw KN, Gorelick M, McGowan KL, Yakscoe NM, Schwartz JS. Prevalence of urinary tract infection in febrile young children in the emergency department. Pediatrics. 1998 Aug 1;102(2):e16.

Newman TB, Bernzweig JA, Takayama JI, Finch SA, Wasserman RC, Pantell RH. Urine testing and urinary tract infections in febrile infants seen in office settings: the Pediatric Research in Office Settings' Febrile Infant Study. Arch Pediatr Adolescent Med. 2002 Jan 1;156(1):44-54.

Herr SM, Wald ER, Pitetti RD, Choi SS. Enhanced urinalysis improves identification of febrile infants ages 60 days and younger at low risk for serious bacterial illness. Pediatrics. 2001;108:866­871.

Srivastava RN, Bagga A. Urinary tract infection. In: Pediatric Nephrology, 5th ed. New Delhi: Jaypee Brothers; 2011:273-300.

Kaushal RK, Bansal S, Sharma VK, Sood A, Goyal A. Urinary tract infection among children presenting with fever. Indian Pediatr. 2003;40:269-70.

Messi G, Peratoner L, Paduano L, Marchi AG. Epidemiology of urinary tract infections and vesico-ureteral reflux in children. Helvetica Paediatr Acta. 1989 Jun;43(5-6):389-96.

Nayir A. Circumcision for the prevention of significant bacteriuria in boys. Pediatr Nephrol. 2001 Dec 1;16(12):1129-34.

Hoi LV1, Sarol JN Jr, Uriarte RD, Tadoy SA. Urinary Tract Infection in children: diagnosis, treatment and long-term management. Southeast Asian J Tropical Medi Public Health. 2000; 31(Suppl 1):162-6.

Hansen A, Hansen B, Dahm TL. Urinary tract infection, day wetting and other voiding symptoms in seven‐to eight‐year‐old Danish children. Acta Paediatr. 1997 Dec;86(12):1345-9.

Tseng MH, Lin WJ, Lo WT, Wang SR, Chu ML, Wang CC. Does a normal DMSA obviate the performance of voiding cystourethrography in evaluation of young children after their first urinary tract infection?. J Pediatrics. 2007 Jan 1;150(1):96-9.

Parada JP, Jain P, David A, Smith GL. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Archives Inter Med. 1995;155:1425-9.

Tsai JW, Lin CC, Yang SS. Diagnosis of pediatric urinary tract infection. Urological Science. 2016;27:131-4.

Honkinen O, Lehtonen OP, Ruuskanen O, Huovinen P, Mertsola J. Cohort study of bacterial species causing urinary tract infection and urinary tract abnormalities in children. BMJ. 1999 Mar 20;318(7186):770-1.

Hashemiparast MS, Shojaeizadeh D, Aezam K, Tol A. Effective factors in urinary tract infection prevention among children: Application of Health Belief Model. Open Preventive Med. 2015 Feb 4;5(02):72.