Clinical and Microbial Etiology Characteristics in Pediatric Urinary Tract Infection

Abstract

BackgroundUrinary tract infection (UTI) is a common occurrence in children. UTI and urological malformations are intimately linked. However, whether urinary tract malformations affect the clinical features of pediatric UTI remains unclear. The purpose of this study was to characterize the clinical features and microbial etiology of UTI in children.MethodsWe retrospectively reviewed the records of 741 patients with UTI treated at the Chongqing Medical University Affiliated Children's Hospital between 2015 and 2020. Patients with and without urological malformations were compared using propensity score matching (PSM).ResultsEscherichia coli was the most common causative microorganism of UTI, accounting for 40.5% of infections. One hundred twenty-two patients (16.5%) had urological malformations. PSM identified 122 matched pairs of patients with or without urological malformations. The proportion of patients with UTI caused by atypical microorganisms was significantly higher in patients with urological malformations (P = 0.048). Children with urological malformations showed longer duration of intravenous antibiotic treatment (P = 0.010), higher cost of treatment (P < 0.001), and higher prevalence of recurrence (23.8 vs. 10.7%, P < 0.001), compared with the normal group.ConclusionChildren with urological malformations are more likely to develop UTI with atypical microorganisms. Appropriate imaging examination and urine culture are strongly recommended for the diagnosis and management of pediatric UTI.

Study of Antibiotic-resistant Bacteria Isolated from Children with Urinary Tract Infection

“…Lu 5 referred to the percentage of E. coli, K. pneumoniae, P. aeruginosa, S. epidermidis, E. aerogenes, C. freundi) causing UTI in children were (40.5, 8.9, 4.3, 2.0, 0.9, 0.5%), respectively. 6 noted that E. coli, P. aeruginosa and Proteus were more likely to cause UTI and were formed (19.1, 14.3, 11.9%), respectively.…”

“…4 Bacteria (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus epidermidis, Enterobacter aerogenes and Citrobacter freundi) are a species of bacteria causing UTIs in children. 5 E. coli bacteria make up 80-90% of urinary tract injuries in children. 4 E. coli, P. aeruginosa and Proteus spp.…”

Urinary Tract Infections in Children: Clinical and Antibiotic Susceptibility Data from a Tertiary Care Hospital

“…The midstream clean catch method was used to obtain urine samples in toilet-trained children, while the urine specimen was collected via urethral catheterization in those without sphincter control. Growth of >10 5 single colony-forming units (CFU/mL) in the midstream clean catch method and >5 4 CFU/mL in the catheterized specimen of urine was considered as UTI (1,2). Urine dipstick analysis with the presence of nitrites or leucocyte esterase or pyuria was documented as positive.…”

“…Urinary tract infections (UTIs) are among the most common bacterial infections in children (1), affecting approximately 8% of this population (2). The incidence of UTIs is higher among boys until the age of 1 year; however, girls have more UTIs over 1 year of age.…”

“…The most common bacterial pathogen is Escherichia coli (E. Coli) (1,2). The gold standard for the diagnosis of UTIs is urine culture, but it takes 48-72 hours to identify appropriate antibiotics for treatment in antibiogram reports (5).…”