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Transurethral Induction of Mouse Urinary Tract Infection
Published on: August 5, 2010
Pediatric urinary tract infections in a tertiary care center from north India
Neelam Taneja1, Shiv Sekhar Chatterjee, Meenakshi Singh
1Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India. drneelampgi@yahoo.com
Insights
Pediatric urinary tract infections (UTIs) are common in young males and infants, often linked to vesicoureteric reflux and posterior urethral valves. Most UTIs were nosocomial and caused by multi-drug resistant pathogens.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Nephrology
Background:
- Pediatric urinary tract infections (UTIs) are linked to significant morbidity, including renal scarring and chronic kidney disease.
- Undiagnosed febrile illnesses in children can stem from UTIs, highlighting the need for prompt diagnosis.
- Understanding the clinical, microbiological, and resistance profiles of pediatric UTIs is crucial for effective management.
Purpose of the Study:
- To investigate the clinical and microbiological characteristics of pediatric UTIs.
- To determine the antibiotic resistance patterns of common uropathogens in children.
- To identify risk factors associated with UTIs in the pediatric population.
Main Methods:
- Collected mid-stream urine samples from 1974 children under 12 years over six months.
- Utilized microscopy and culture on specialized media for UTI diagnosis.
- Identified bacterial isolates and performed antimicrobial sensitivity testing.
Main Results:
- Identified significant bacteriuria in 28.3% of children, with common risk factors including male gender, age < 1 year, vesicoureteric reflux (VUR), and posterior urethral valve (PUV).
- Escherichia coli was the most frequent uropathogen (47.1%), followed by Klebsiella spp. (15.6%).
- High in-vitro resistance was observed among Enterobacteriaceae, and 12% of Enterococcus strains were vancomycin-resistant. Notably, 93.4% of UTIs were nosocomial.
Conclusions:
- Pediatric UTIs are prevalent in infants and young males, particularly those with VUR and PUV.
- The study identified a predominance of nosocomial, multi-drug resistant pathogens causing UTIs in this pediatric cohort.
- Effective antibiotic stewardship and infection control measures are essential for managing pediatric UTIs.
Background & Objectives:
Paediatric urinary tract infections (UTI) are associated with high morbidity and long term complications like renal scarring, hypertension, and chronic renal failure. A cause of occult febrile illness, they often remain undiagnosed. We studied the clinical and microbiologic profile and antibiotic resistance profile of such infections in paediatric UTI patients at our center.
Methods:
Clean catch mid-stream urine samples for culture were received from 1974 children aged<12 yr over a period of 6 months.Quantitative wet mount microscopy and semiquantitative culture on cysteine lactose electrolyte deficient medium were done to diagnose UTI. Isolates were identified by standard biochemical tests and antimicrobial sensitivity was determined. Clinical details including risk factors and underlying illness were noted.
Results:
Significant bacteriuria was found in 558 children (28.3%). Male gender (25.6%), age<1 yr (77.5%), vesicoureteric reflux disease (VUR) (19.9%) and posterior urethral valve (PUV) (27.6%) were common risk factors in children suffering from UTI.Pyuria was detected in 53.6 per cent of infections. Common uropathogens isolated were Escherichia coli (47.1%), Klebsiella spp. (15.6%), Enterococcus fecalis (8.7%), members of tribe Proteae (5.9%), Pseudomonas aeruginosa (5.9%) and Candida spp. (5.5%). Against lactose fermenting Enterobacteriaceae, in-vitro resistance was least against amikacin (32.5%), nitrofurantoin (26.7%) and imipenem (3.7%). Among enterococci, vancomycin resistant enterococci constituted 12 per cent of the strains. 93.4 per cent of the UTI detected was nosocomial.
Interpretation & Conclusion:
Paediatric UTI was common in children with male gender, age<1 yr, and in children suffering from VUR and PUV. Spectrum of pathogens causing paediatric UTI in our center had a preponderance of nosocomial multi-drug resistant pathogens.
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