Urinary tract infections in African infants

Urinary tract infection (UTI) causes significant illness in the first 2 years of life. The diagnosis in most developing countries is often overlooked due to the tedious nature of obtaining urine from these young ones who would not void voluntarily. Misdiagnosis very often lead to avoidable ill health and long-term renal damage. There is a need to diagnose UTI in febrile infants to alert clinicians. A prospective study of febrile infants aged up to 12 months on admission was undertaken in a 6-months period. Urine specimen was obtained by supra pubic aspiration and investigated. Out of 150 urine samples screened for UTI, 45 (30%) had positive bacterial growth. Escherichia coli (32%) and Proteus sp. (22%) formed more than 50% of the total isolates. The Gram positive bacteria isolated was Staphylococcus aureus representing 11%. All isolates were susceptible to cefuroxime and resistant to ampicillin. Susceptibility to amoxicillin/clavulanic acid was 77.8% and to nitrofurantoin was 67%. Only 11.1% of isolates were susceptible to cotrimoxazole. These results indicate that UTI is a common cause of pyrexia in infants requiring admission. These infants when clinically diagnosed as having UTI are treated with ampicillin and cotrimoxazole. They do not have the benefit of further investigation for renal abnormalities and subsequent antibiotic prophylactics to prevent recurrent infection, which could result in renal scarring and its associated problems later.