Published: 2020-05-26

Clino-pathological features of urinary tract infection: a study at Nishtar University Hospital Multan, Punjab, Pakistan

M. Faisal Mehar, Rabia Saleem Safdar, Afsheen Asghar Khan, Madiha Naz, Bushra Iqbal, Ali Rehan Nasir


Background: Urinary tract infection (UTI) is a common clinical issue among pediatric population and might progress into renal scaring, hypertension as well as end stage kidney disease. This study was aimed at finding clino-pathological features of UTI and antibiotic sensitivity against most common causative agents involved at a tertiary care hospital of South Punjab, Pakistan.

Methods: This descriptive case series study was conducted at department of Paediatric Medicine, Nishtar University Hospital Multan from July to December 2019. A total of 100 children fulfilling the inclusion criteria, presenting in outpatient department or emergency section of paediatric medicine department, having positive urine culture and sensitivity were selected. Their detailed history, clinical examination and relevant investigations were done.

Results: Out of the 100 children, 73 (73.0%) were female and 27 (27.0%) were male. There were 57 (57.0%) children from 1 year to 4 years age group and 43 (43.0%) were of more than 4 years. Most common clinical presentations were fever 83 (83.0%), urinary symptoms, vomiting 52 (52.0%) and pain abdomen 48 (48.0%). Most common aetiological agents were Escherichia coli 74 (74.0%) and Klebsiella pneumoniae 9 (9.0%).

Conclusions: UTI is more common in female children. Most common presentation observed was fever and/or urinary symptoms while most common aetiological agent was E. coli.


Escherichia coli, Dysuria, Fever, Failure to thrive, Urinary tract infection

Full Text:



Doern CD, Richardson SE. Diagnosis of Urinary Tract Infections in Children. J Clini Microbiol. 2016;54(9):2233-42.

Shrestha LB, Baral R, Poudel P, Basudha K. Clinical, etiological and antimicrobial susceptibility profile of pediatric urinary tract infections in a tertiary care hospital of Nepal. BMC Pediatr. 2019;19:36.

Shaikh N, Mattoo TK, Keren R, Ivanova A, Cui G, Moxey-Mims M, et al. Early Antibiotic Treatment for Pediatric Febrile Urinary Tract Infection and Renal Scarring. JAMA Pediatr. 2016;170:848.

Elder JS. Urinary tract infections. In: Klegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE, eds. Nelson Textbook of pediatrics. 20th ed. Philadelphia: Elsevier; 2016: 2556-2561.

Lacromb J. Urinary tract infection in children. BMJ Clin Evid. 2010;2010:3-6.

Leung AK, Wong AH, Leung AA, Hon KL. Urinary Tract Infection in Children. Recent Pat Inflamm Allergy Drug Discov. 2019;13(1):2-18.

Stein R, Dogan HS, Hoebeke P, Kočvara R, Nijman RJ, Radmayr C. Urinary tract infections in children: EAU/ESPU guidelines. Eur Urol. 2015;67(3):546-58.

Koçak M, Büyükkaragöz B, ÇelebiTayfur A, Çaltik A, Köksoy AY, Çizmeci Z, et al. Causative pathogens and antibiotic resistance in children hospitalized for urinary tract infection. Pediatr Int. 2016;58:467-71.

Badhan R, Singh DV, Badhan LR. Evaluation of bacteriological profile and antibiotic sensitivity patterns in children with urinary tract infection. Ind J Urology. 2016;32(1):50-6.

Elder JS. Urologic disorders in infants and children. In: Behraman RE, Kleigman RM, Jenson HB, eds. Nelson's textbook of pediatrics. 17th ed. Philadelphia: W.B. Saunders; 2004:1783-1826.

Jamil J, Haroon M, Sultan A, Khan MA, Gul N, Kalsoom. Prevalence, antibiotic sensitivity and phenotypic screening of ESBL/MBL producer E. coli strains isolated from urine; District Swabi, KP, Pakistan. JPMA. J Pak Medi Assoc. 2018 Nov 1;68(11):1704-7.

Asinobi AO, Fatunde OJ, Brown BJ, Osinusi K, Fasina NA. Urinary tract infection in febrile children with sickle cell anaemia in Ibadan, Nigeria. Anna Trop Paediatrics. 2003 Jun 1;23(2):129-34.

Mansoor IY, AL-Otraqchi KI, Saeed CH. Prevalence of urinary tract infections and antibiotics susceptibility pattern among infants and young children in Erbil city. Zanco J Medi Sci. 2015;19(1):915-22.

Abuhandan M, Güzel B, Oymak Y, Çiftçi H. Antibiotic sensitivity and resistance in children with urinary tract infection in Sanliurfa. Turkish journal of urology. 2013 Jun;39(2):106.

Qureshi AM. Clinical presentation of urinary tract infection among children at Ayub Teaching Hospital, Abbottabad. Journal of Ayub Medical College Abbottabad. 2005;17(2):79-81.

Moorani KN, Parkash J, Lohano MK. Urinary tract infection in children undergoing diagnostic voiding cystourethrography. J Surg Pak. 2010 Apr;15:68-72.

Ahmad A, Hussain W, Waqar S, Khan A. presenting features of urinary tract infection (UTI) in children: a hospital based study. Pak Paed J. 2006;30:91-4.

Mirsoleymani SR, Salimi M, Shareghi Brojeni M, Ranjbar M, Mehtarpoor M. Bacterial pathogens and antimicrobial resistance patterns in pediatric urinary tract infections: a four-year surveillance study (2009–2012). Int J Pediatr. 2014;2014.

Singh SD, Madhup SK. Clinical profile and antibiotics sensitivity in childhood urinary tract infection at Dhulikhel Hospital. Kathmandu University Medi J. 2013;11(4):319-24.

Hussain M. Bacteriological spectrum and sensitivity pattern in culture proven urinary tract infection in children. J Rawalpindi Medi Coll. 2017 Sep 30;21(3):290-2.

Ali I, Rafaque Z, Ahmed S, Malik S, Dasti JI. Prevalence of multi-drug resistant uropathogenic Escherichia coli in Potohar region of Pakistan. Asian Pacific J Trop Biomedi. 2016;6(1):60-6.

Dalhoff A. Global fluoroquinolone resistance epidemiology and implictions for clinical use. Interdisc Perspectiv Infect Dis. 2012;2012.