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Published on: August 12, 2020
Prevalence of bacteriuria in febrile infants
V R Dharnidharka1, P W Kandoth
1Department of Pediatrics, T.N. Medical College, Bombay.
Insights
Bacteriuria is common in febrile infants, particularly in females with gastroenteritis. Routine urine cultures are recommended for these high-risk patients to ensure timely diagnosis and treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Urology
Background:
- Febrile infants often present with non-specific symptoms, making accurate diagnosis challenging.
- Urinary tract infections (UTIs) can be a significant cause of fever in infants.
- Identifying risk factors for bacteriuria in this population is crucial for effective management.
Purpose of the Study:
- To determine the prevalence of bacteriuria in admitted febrile infants.
- To identify clinical characteristics associated with positive urine cultures.
- To assess antibiotic susceptibility patterns in infant UTIs.
Main Methods:
- 129 febrile infants underwent suprapubic aspiration for urine collection.
- Samples were analyzed via urinalysis, culture, and antibiotic sensitivity testing.
- Statistical analysis (chi-squared and Z-tests) was used to identify significant associations.
Main Results:
- 7% of infants had positive urine cultures, with E. coli and Klebsiella being the most common pathogens.
- Female infants, especially those with gastroenteritis, showed a higher incidence of bacteriuria.
- All isolates were sensitive to ciprofloxacin, with variable sensitivity to other antibiotics and uniform resistance to ampicillin and chloramphenicol.
Conclusions:
- Bacteriuria is prevalent in febrile infants, even with other concurrent illnesses.
- Female infants with gastroenteritis are at increased risk for UTIs.
- Routine urine culture is warranted in febrile infants to detect UTIs.
Abstract:
Urine samples from 129 admitted febrile infants were collected using the suprapubic aspiration technique, and subjected to routine urinalysis, culture, and antibiotic sensitivity testing. Most of the infants suffered from respiratory tract infections (n = 80) and gastroenteritis (n = 25). Sixty nine patients were male and sixty female. In all, 7 patients had positive cultures (5.4%), indicating a high yield (> 5%). Six of these were female and occurred in patients with gastroenteritis (p < 0.05 for both by chi 2 and Z test). Four patients showed pus cells and organisms on smear, and all of them were culture positive. Another three had only pus cells, but were also culture positive. One patient each, who had pus cells only or organisms only on smear had no growth on culture. E. coli was grown in 6 of these cases, and Klebsiella in one. All cultures were sensitive to ciprofloxacin. Variable sensitivity was seen with gentamicin, streptomycin, and furadantin. The organisms were uniformly resistant to ampicillin and chloramphenicol. The procedure of suprapubic aspiration was safe with no complications. Our findings indicate that bacteriuria is not uncommon in febrile infants even with clinical evidence of other illnesses and that female children, especially those with gastroenteritis, are at most risk. Routine urine cultures in such patients would appear justified.
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