Clinical profile and renal anomalies associated with culture positive urinary tract infection in children attending the University Nephrology Clinic at Lady Ridgeway Hospital for Children, Colombo, Sri Lanka

Vollständiger Abstract

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Introduction: Urinary tract infection (UTI) is a leading bacterial infection in childhood. The prevalence varies according to gender and age. Children with anomalies are more susceptible to UTI. Objectives: To describe the clinical characteristics and associated renal anomalies in children with culture-positive UTIs in a single centre. ethod: A cross-sectional study was conducted among children aged 0–14 years referred for specialized nephrology care. UTI was defined as symptomatic, culture-positive with ≥10⁵ colony forming units (CFU) in midstream urine or any CFU in suprapubic aspiration. Children with learning disabilities, neuropsychiatric disorders, or unreliable parental history were excluded. Results: Of 166 patients, 111 (66.9%) were male. The mean age was 6.84±3.91 years, with a mean birthweight of 2.8±0.5 kg. For 57 (34.3%), it was the first UTI episode, with up to 10 episodes reported. Common symptoms included fever (75.3%, n=125), excessive crying (46.4%, n=77), poor stream (33.7%, n=56), frequency and intermittency (both occurred in 33.7% (n=56), dysuria (32.5%, n=54), backache and flank pain (4.2%, n=7). Predisposing factors included constipation (31.9%, n=53), phimosis (12.7%, n=21), and poor hygiene (2.4%, n=4). Ultrasound was performed in 149 (89.8%), with 35 (21.1%) showing no abnormalities and 91 (54.8%) revealing upper tract pathology. Micturating cystourethrogram (MCUG) and diethylene triamine penta-acetate (DTPA) scans were conducted in 45.8% and 49.4% of cases, respectively. Conclusions: In this single centre study, in 166 children, aged 0–14 years with culture-positive UTI, there were 66.9% males. Mean age was 6.84±3.91 years. Common symptoms were fever, excessive crying, poor stream, frequency, intermittency, backache and flank pain. Predisposing factors included constipation, phimosis and poor hygiene. Ultrasound scan, performed in 1149 children, showed abnormalities in 91(61.1%).