Clinical and laboratory aspects of urinary tract infections in hospitalized children

Background: urinary tract infection (UTI) is the most common disease of urinary system and second common infection in children. Approximately, 5% of girls and 1% of boys have experienced a UTI by 11 years of age. The aim of this study was to determine clinical and laboratory aspects of urinary tract infection in hospitalized children in Razi Hospital of Kermanshah, Iran during 2001-2005.

Methods: This study is a descriptive one considered to evaluate profiles of 462 patients with UTI. UTI was defined as WBC>5  per high power microscopic field and positive culture or passive U/A , clinical symptoms and positive urine culture. Finding data were analyzed using SPSS (13) software.

Results: Among 462 patients, 306 cases (66%) were female and 156 cases (34%) were male (f/m=1.94). 69.4% of patients were under 2 year and 13.8% of them were  older than 5 years. The sonographic findings were normal in 216/392 (55%) of patients. The organisms isolated in urine culture were Ecoli in 240 (53%), Proteus in 34(7%) and klebsiella in 29 (6%) of subjects. The most common manifestation of UTI was fever (48%). In addition, in 81 cases there was an other infection associated with UTI that gastroenteritis was the most common associated infection.

Discussion:  Based on prevalence of fever in UTI, we recommend urinalysis as  one of the primary tests in evaluation of febrile children under 2 years (especially in girls). Pyuria with high sensitivity can confirm UTI. Presence of other infections cannot exclude the diagnosis of UTI.