Abstract
Objective To study the pattern of urinary tract
infection (UTI) in children paying special attention to
initial confirmation of diagnosis by urine culture.
Design A prospective study over a period of twelve
months.
Setting Private sector hospitals in Colombo.
Subjects Children presenting with a suspected
diagnosis of UTI.
Investigations UTI was confirmed by a positive urine
culture with a colony count of >105 organisms/ml in a
clean catch sample. Subsequent investigations
included renal ultrasound scans, MCUGs and renal
function tests; IVUs, DMSA & DTPA scans were
done in a few patients.
Results 165 patients (97 boys and 68 girls) were
studied. 54% of patients were under 1 year of age.
Common presenting symptoms were fever (41%),
dysuria (32%), frequency of micturition (15%) and
failure to thrive (8%). The commonest organisms
isolated were E.coli (41%), coliforms (38%) and
Klebsiella (13%). The 2 most common antibiotics
used initially were nalidixic acid and cotrimoxazole.
On investigating further, out of 143 patients who had
ultrasonography, abnormalities were seen in 17
(12%) and in 72 patients who had MCUGs
performed, 17 (24%) showed evidence of
vesicoureteric reflux (VUR). 17 patients were
referred for surgical intervention.
Conclusion A diagnosis of UTI in children should be
established with the "gold standard" of a significantly
positive urine culture before embarking on treatment
and further investigations. Special emphasis should
be paid to the collection and transport of urine. Once
the diagnosis is established, regular follow-up is
essential to prevent renal damage.
Sri Lanka Journal of Child Health, 2001; 30: 31-6
(Key words: urinary tract infections, vesico-ureteric reflux, children, renal damage)
DOI : 10.4038/sljch.v30i2.825
Published on
17 Jul 2009.
Peer Reviewed
