URINARY TRACT INFECTION IN CHILDREN:
AN EPIDEMIC ANALYSIS
Alpay H, Arikan C, Cabukoglu S, Biyikli
N.
Marmara Unıversity
Hospital, Division of Pediatric Nephrology,Turkey
Objectives: To study microorganisms, susceptibility
patterns, risk factors and prevalence of urinary tract infection (UTI),
bacteremic UTI and nosocomial UTI.
Methods: A retrospective hospital record rewiev of
patients who are younger than 16 years with UTI were analyzed. Their
laboratory and imaging findings, antibiotic susceptibility and risk factors
for bacteremic and nosocomial UTI were investigated.
Results: During the study period 564 children
admitted with UTI.The mean age of the children was 48.15¡À43.49 months (0-192 months). The main
microorganisms were Escherichia coli 55.5%, Klebsiella pneumonia 15.1%,
Klebsiella oxytoca 3.7%, Pseudomonas aeroginosa 6.7 %, Proteus mirabilis
6.7%, Enterobactereciae 1.2%, Enterococcus feacalis 3.2%, other bacteria 3%
and Candida 5.1%. Their overall susceptibility patterns were as
follows: aminoglicosides 94%, kinolones 93.8%, the third generation
cephalosporins 88.8%, the second generation cephalosporins 86.7%,
nitrophurantoine 83%, beta lactamase inhibitors 68.3%, TMP-SMX %58.7,
ampicillin and amoxicillin 41.3%. Results from imaging studies revealed VUR in 11% of patients whereas
scars in 13.7% of patients. Nosocomial UTI was detected in 36 patients and
infection rate was 6.1% and 0.79% for neonatal intensive care unit and
pediatric ward respectively. 6.2% of the patients were bacteremic UTI. The
most frequent pathogens in patients with bacteremic and nosocomial UTI was
E. coli and Klebsialla pneumonia respectively. Univariate analysis detected
significant risk factors for nosocomial UTI as follows: long hospital stay
at current admission, use of urinary catheter, existence of antibiotic use
during the current admission.
Conclusıons: According to our data, aminoglicosides, the
second and the third generation cephalosporins are the apropriate choice
for empiric therapy. Risk factors for nosocomial UTIs are should be
investigated prospectively with larger populations.