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

Abstract

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.