Urinary tract infection in malnourished rural African children

Abstract

During an 8-month period from 1 September 1992 to 30 April 1993, 134 children less than 5 years of age admitted with all grades of malnutrition to a rural hospital were investigated for urinary tract infection. Thirty-five (26.1%) had proven infection. Incidence rates amongst malnutrition categories did not vary significantly. Antibiotic sensitivities with reference to ongoing surveillance and antimicrobial usage is discussed. The value of dipstick screening tests was analysed for predictability and found to be an unreliable alternative to traditional culture techniques. This study emphasizes that urinary tract infection in malnutrition is common and should be routinely investigated.

Bacteriuria and urinary tract infections in malnourished children

“…UTI cause acute morbidity and may result in renal scarring and its complications. A number of reports, mainly from developing countries, indicate a high incidence of bacteriuria in malnourished children [2,3,4,5,6,7,8,9,10,11,12,13]. However, most studies have either not prospectively compared the incidence of bacteriuria in malnourished and normally nourished children [2,3,4,5,8,9,10,13], or have not found significant differences [6,7,11].…”

Study of ecology of malnutrition with respect to infection, infestation pattern, immunization and feeding practices in children attending tertiary care hospital

“…Shimeless D et al had reported 32% case fatality rate due to septicemia, gastroenteritis, pneumonia and disseminated tuberculosis and Reed RP et al had reported 20.8% case fatality rate in severe malnourished children. 11,15 Low case fatality rate noted in our study may be due to reduction in mortality due to diarrhea.…”

Antibiotics in severely malnourished children: systematic review of efficacy, safety and pharmacokinetics

“…Moreover, high rates of in vitro resistance to ampicillin and gentamicin have been reported in several African countries (Table 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] According to discussions with staff members, institutions for the care of malnourished children vary in the degree to which they follow current recommendations. Many institutions are now giving more potent broad-spectrum antibiotics to hospitalized malnourished children guided largely by local in vitro sensitivity data.…”

“…2,3 Rationale for antibiotics in severely malnourished children Several epidemiological studies have documented a high prevalence of pneumonia, bacteraemia and urinary tract infections in children with malnutrition (Table 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In this cohort a wide range of both Gram-positive and Gram-negative organisms are Objective To systemically review the evidence in support of World Health Organization guidelines recommending broad-spectrum antibiotics for children with severe acute malnutrition (SAM). Methods CENTRAL, MEDLINE, EMBASE, LILACS, POPLINE, CAB Abstracts and ongoing trials registers were searched.…”

“…[10][11][12][13][14][15] High rates of resistance to second-line antibiotics such as chloramphenicol, gentamicin and cephalosporins have also been reported in selected contexts, [12][13][14][15] while in general, sensitivity to ciprofloxacin remains high (Table 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In vitro resistance, however, does not necessarily translate into lack of clinical efficacy.…”