Clinical Profile and Antibiotic Sensitivity Pattern of Community Acquired Urinary Tract Infections in Children Attending a Tertiary Care Hospital in Assam, India

Abstract

Introduction: Urinary Tract Infection (UTI) is a common problem in children. It is a very common cause of fever in children after gastrointestinal and respiratory diseases. Uropathogens causing community acquired UTI is increasing due to changing antibiotic sensitivity pattern over time. Appropriate choice of antibiotic is crucial to prevent complications related to UTI. Aim: To study the clinical profile, risk factors, associated pathogen spectrum and their antibiotic sensitivity pattern in community acquired UTI. Materials and Methods: A cross-sectional observational study with 150 sample size was conducted in the Department of Paediatrics, Gauhati Medical College and Hospital, Guwahati, Assam, India and was carried out among children (1 month to 12 years of age) with community acquired UTI, over a period of one year in the state of Assam. Fresh urine samples were collected by clean catch mid-stream method for toilet trained children and by transurethral catheterisation for infants and young children. It was followed by routine urine examination and culture and sensitivity testing to diagnose UTI. Descriptive statistics was used to describe the results. Proportion test was used for statistical evaluation. Results: Majority of UTI cases were in the age group 1 to 5 years (57.3%) and there was female preponderance (59.3%). Fever was the most common presentation (55.3% cases) in the present study. This was followed by poor feeding (12.6%), lower abdominal pain (10.6%), failure to gain weight (10.6%). In urinalysis, 87 cases (58%) showed pyuria, 6 cases (4%) showed significant haematuria. Most prevalent uropathogens in the present study was Escherichia coli (E.coli) (66%cases), followed by Enterococcus sp. (16.7%), Klebsiella sp. (14%). E.coli had maximum sensitivity for nitrofurantoin (90.9%). It was followed by amikacin (80%), co-trimoxazole in 64.6% and gentamycin in 62.6% cases. Conclusion: All fever cases in children should be screened to rule out UTI. All UTI cases should undergo culture and sensitivity testing to determine the sensitivity pattern.