Prevalence of urinary tract infection in febrile children of less than five years of age

Abstract

To determine the prevalence of urinary tract infection in febrile children, less than 5 years of age. To assess the validity of microscopic urine analysis and urine culture in the diagnosis of urinary tract infection.Prospective study. Children attending   the department of paediatrics, Dr.V.R.K. Women’s Medical College, Teaching Hospital & Research Centre, with febrile illness during June 2019-June 2020.370 children between 1 month to 5 years of age.Data related to age, sex, nutritional status, socioeconomic status and predisposing risk factors like urethral instrumentation, bowel habits etc, were noted. A thorough physical examination with relevant investigations were carried out in all these patients. Routine urinary microscopy was done in all patients and urine culture was done in those who showed pyuria of >5 pus cells/HPF in centrifuged urine sample.In our study, overall prevalence of UTI was 3.5% in children between 1 month to 5 yrs and 4.1% in children <2yrs and 7% in Children <1 year of age with M:F ratio of 1:1in children <2yrs. Prevalence of culture positivity was 44% in those who showed >10 pus cells/HPF in centrifuged sample of urine and 2.5% in those who showed >5pus cells/HPF.The presence of obvious source of fever such as upper respiratory tract infection or otitis media is not reliable in excluding urinary tract infection. Overall prevalence of UTI in our study was low (3.5%) and prevalence among children <2yrs was 4.1% and <1 year of age was 7%. Pyuria of >5pus cells/HPF (centrifuged urine sample) should be considered as significant and further evaluation should be done to initiate prompt treatment.