Prevalence of urinary tract infection among preschool febrile children attending the pediatric OPD

Abstract

Background: Urinary tract infection (UTI) is one of the most common bacterial illness among febrile infants and preschool children with a reported prevalence between 4.1% and 7.5%. The objective of this study was to know the prevalence of urinary tract infection in preschool febrile children.Methods: Cross sectional study conducted in pediatric OPD of a Government teaching hospital with 500 febrile preschool children aged 3 to 6 years. Results: Prevalence of UTI in febrile preschool children aged 3-6 years was 2.9% in males and 5.5% in females with overall prevalence of 4%. 15% had temperature > 39.3 oC. 45% had dysuria, 35% had vomiting. 25% and 20% had increased frequency and burning micturition respectively. 70% patients with UTI and 30% cases without UTI had proteinuria. 95% patients had pus cells > 5 per HPF. 60% patients had bacteria in their urine where as in culture negative cases only 1.04% had bacteria. E coli was the common organism isolated (80%), followed by Klebsiella. Majority were resistant to Ampicillin (55%). 75% of microorganisms were sensitive to ceftriaxone. 70% were sensitive to gentamycin, norfloxacin and cephalexin. 5% UTI cases had RFT. KUB X-ray was normal in all the cases. 20% of cases showed features suggestive of acute pyelonephritis on Ultrasonography. 1 out of 4 Patients who underwent Intravenous pyelography showed hydronephrosis. 2 out of 4 cases showed VUR in MCU.Conclusions: UTI is a potential cause of fever in children below 6 years of age. Urine culture is the gold standard for diagnosis of UTI in children. Parents should be educated about the importance of UTI and its long-term complications.