Comparison of Clinical, Etiological and Antibiotic Sensitivity Patterns of UTI in CAKUT and Non CAKUT Children

Ali Raza Jafri; Naureen Akhtar; Adeela Chaudhry; Abdul Wahid Hussain; Junaid Rashid; Naima Mehdi

doi:10.35787/jimdc.v13i3.1194

Ali Raza Jafri AMC
Naureen Akhtar The Children’s Hospital, and The University of child health sciences, Lahore
Adeela Chaudhry The Children’s Hospital, and The University of child health sciences, Lahore
Abdul Wahid Hussain The Children’s Hospital, and The University of child health sciences, Lahore
Junaid Rashid The Children’s Hospital, and The University of child health sciences, Lahore
Naima Mehdi The Children’s Hospital, and The University of child health sciences, Lahore

DOI: https://doi.org/10.35787/jimdc.v13i3.1194

Keywords: Pediatric UTI, CAKUT, Antibiotic, Sensitivity, Resistance

Abstract

Background: Urinary tract infections (UTIs) are one of the most common bacterial infections in children. Congenital anomalies of the kidney and urinary tract (CAKUT) are a major cause of UTIs in this population.

Objective: To compare clinical, etiological and antibiotic sensitivity patterns of UTIs in CAKUT and non-CAKUT children.

Study Design: Prospective comparative study.

Place and Duration: The study was conducted at the department of Pediatric Nephrology, The Children's Hospital Lahore from August 2023 to January 2024.

Methods: 68 children with and without CAKUT having UTI were evaluated. Data regarding demographics, clinical presentation and antibiotic sensitivity pattern was collected. Susceptibility testing was done according to CLSI recommendations.

Results: 34 patients with UTI in CAKUT group (Group A) had male predominance (73.5%) while children without CAKUT (Group B) were predominantly females (55.9%). Mean age in Group A (38.9 months) was less than that in Group B (53.9 months). The common presentations in both the groups were pyelonephritis and cystitis. Vesico-ureteric reflux (32.4%) and posterior urethral valves (29.4%) were the most common CAKUT findings. Majority of patients with CAKUT had Pseudomonas UTI (32.4%) while E. coli (35.3%) was common in children without CAKUT. Fosfomycin, Colistin, Linezolid and Polymyxin B had low resistance amongst both groups. The association between CAKUT and atypical uropathogens was not found to be statistically significant (p = 0.287).

Conclusion: Differences exist in clinical presentation, etiology and antibiotic sensitivity patterns specific to UTI in CAKUT and non-CAKUT children. A high resistance pattern was found amongst common antibiotics.

Author Biographies

Naureen Akhtar, The Children’s Hospital, and The University of child health sciences, Lahore

Professor of Pediatric Nephrology, Department of Pediatric Nephrology

Adeela Chaudhry , The Children’s Hospital, and The University of child health sciences, Lahore

Assistant Professor of Pediatric Nephrology, Department of Pediatric Nephrology

Abdul Wahid Hussain, The Children’s Hospital, and The University of child health sciences, Lahore

Fellow Pediatric Nephrology, Department of Pediatric Nephrology

Junaid Rashid, The Children’s Hospital, and The University of child health sciences, Lahore

Professor of Pediatric medicine, Medical Unit 1

Naima Mehdi, The Children’s Hospital, and The University of child health sciences, Lahore

Assistant Professor of Pediatric Microbiology, Department of Pediatric Microbiology