Objective: To determine the frequency of urinary tract infection (UTI) in febrile children at Prince Rashed Bin Al Hasan Hospital, Irbid, Jordan.
Methodology: This descriptive study includes boys and girls from age two months to 14 years with fever (>38.5°C) who did not have a definite source for their fever on physical examination who were admitted to the pediatric ward from January 1, 2013 to December 31, 2013. And patients with symptoms of change in color of urine, offensive odor, hematuria, abdominal and suprapubic tenderness, dysuria and frequency were included in the study. Patients who had chest infection, bronchiolitis, otitis media, gastroenteritis, and convulsions were not included. Urine cultures were were considered positive if growth of a single pathogen at 10^5 cfu/ml was found. Urine cultures were collected for all patients included in the study under complete aseptic techniques and by suprapubic urine aspiration for patients up to one year old , by catheterization for toilet trained and older children up to 5 years old and by Mid stream urine sample for patients up to the age of 14 years. Urine analysis, complete blood count (CBC), C-reactive protein and Erythrocyte sedimentation rare (ESR) were done. Renal ultrasounds, DMSA Scans and micturating cystourethrogram (MCUG) were also done. Microorganism positive cultures were divided into two groups: E. coli positive and non-E. coli positive cultures group. Microorganisms and their anti-microbial sensitivity were studied.
Results: During the study period, 2347 cases were admitted with fever and symptoms of UTI; 1340 (57%) were males and 1007 (43%) were females. A total of 1331 urine cultures were considered positive. The E. coli positive cultures were in 1211 (91%); 854 (70.5%) were females and 357 (29.5%) were males. In the 120 (9%) Non-E. coli positive cultures 68 (57%) were males and 52 (43%) were females. Non E. coli included Klebsiella (47%), proteus (20%), Pseudomonas (16.6%), Citrobacter (8.3%), Enterobacter (6.5%), and Enterococcus (3.3%). 68 (57%) were males and 52 (43%) were females. E. coli UTIs were more common in females and non E. coli UTIs were more common in males. 1291 (97%) patients were admitted for the first time and 40 (3%) were at least twice. Most organisms (84.1%) were sensitive to gentamycin. Both organisms were least sensitive to ampicillin; E. coli (19%) and Non E. coli (15%).
Conclusion: E. coli UTI was more common in females and the non E. coli species which were common in males. The frequency of UTI in febrile children is difficult to estimate exactly as we cannot exclude UTI in patients with specific findings of higher fever.
Key words: Urinary tract infections, uropathogens, febrile children
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