Paediatric Urinary Tract Infection: A Hospital Based Experience

Area of Science:

• Pediatrics
• Infectious Diseases
• Urology

Background:

• Pediatric Urinary Tract Infection (UTI) is a common concern for pediatricians.
• Untreated UTIs in children can lead to severe long-term consequences, including renal scarring.
• This study investigated the prevalence of UTI in febrile children in the Kashmir province.

Purpose of the Study:

• To determine the prevalence of UTI in febrile children.
• To evaluate the sensitivity of various imaging modalities in diagnosing UTI.
• To assess the diagnostic accuracy of Renal and Urinary Bladder Ultrasonography (RUS), Voiding Cystourethrography (VCUG), and Dimercaptosuccinic Acid (DMSA) scans.

Main Methods:

• A cohort of 304 febrile children aged 2 months to 10 years without a clear source of fever and not on antibiotics were enrolled.
• Urine analysis, culture, RUS, and VCUG were performed for suspected UTI cases.
• DMSA scans were conducted 6 months post-diagnosis to assess renal scarring in culture-proven UTI patients.

Main Results:

• The prevalence of UTI in febrile children without an apparent cause was 13.2% (40/304).
• Escherichia coli was the most common pathogen, followed by Klebsiella and Citrobacter species.
• VCUG detected Vesicoureteral Reflux (VUR) in 55% of cases, while RUS had a sensitivity of 45% for VUR detection. Renal scarring was observed in 25% of patients.

Conclusions:

• Timely diagnosis and treatment of febrile UTI in children are essential to prevent adverse outcomes.
• Imaging modalities like VCUG are more sensitive than RUS in detecting VUR.
• A significant percentage of children with UTI develop renal scarring, highlighting the importance of prompt management.