Risk factors for urinary tract infection in pediatric patients

Abstract

INTRODUCTIONIn the world wide pediatric age group urinary tract infection remains as silent yet very frequently faced infection. It produces significant mortality and morbidity among pediatric population due to inconspicuous clinical manifestations. It results in significant morbidity by producing irreversible damage to renal system that can never be salvaged if not recognized and treated early. Hence early recognition of subtle symptoms and signs will definitely provide good outcome among patients suffering from urinary tract infection.The etiology that predisposes to UTI is not very clear as not much studies are available worldwide to find the exact risk factors.1 If exact risk factors are known knowledge about prevention of risk factors help in the management of urinary tract infection as well as prevent recurrence. The risk factors of UTI depend on socioeconomic status and cultural habits like perineal cleaning methods and diaper usage.2-4 So, it is better to analyse the risk factors in specific cultural groups of different places so that the risk factors which is differing from population to population can be identified and different strategies can be formed for population with Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACTBackground: Urinary tract infection (UTI) is one of the common infections occurring in children causing significant morbidity and mortality. The knowledge about the risk factors helps in the management as well as preventing the recurrence of urinary tract infection. Hence this study aims to assess the various risk factors and profile of UTI. Methods: In this prospective case control study conducted in tertiary care centre between July 2011 to August 2012, children with signs and symptoms suggestive of urinary tract infection and urine culture positive for UTI were included. Age and sex matched asymptomatic children were taken as control. Preformed questionnaire was given to each patient and the results were analysed. Results: Among the 214 cases studied, 111 boys were not circumcised constituting 86.7%. Whereas the other risk factors like recent hospitalisation, recent catheterisation, common toilet usage, cleaning perineum from back to front, constipation, usage of tight underclothing, diaper usage, worm infestation, neurological abnormality, voluntary withholding of urine, reduced water intake constitute 9.3%, 0.5%, 19.6%, 17.4%, 18.2%, 0.9%, 7.9%, 26.2%, 3.7%, 33.6% and 34.6% respectively. Conclusions: Recurrent infection was most often due to unresolved bacteriuria or persistent bacteriuria than reinfection. Signs like supra pubic tenderness and hypertension are very rare. Common organisms causing urinary tract infection in our study population are E. coli followed by Klebsiella, Proteus and Pseudomonas....

Comparative Effectiveness of Antibiotic Treatment Duration in Children With Pyelonephritis

“…We hypothesize that this finding was likely due to differences in risk factors in the aged 4 to 13 years group compared with younger and older children. A possible explanation for the development of UTIs in healthy children less than aged 4 years is evolving elimination and hygiene practices during infancy and toilet training periods 1,[17][18][19] ; whereas children older than 14 years are more likely to experience UTIs related to sexual activity. 16,17 Children between these ages, however, the former.…”