Clinical and etiological profile of Complicated Urinary Tract Infection in Children: A health facility-based cross-sectional study

Background: Urinary tract infection (UTI) is known to be the most frequent bacterial infection in the paediatric population. Objective: To determine the clinical profile and etiology of complicated urinary tract infection (UTI) in children. Methods: This cross-sectional study was done at the Department of Nephrology and Neonatology, National Institute of Child Health, Karachi from 1st January 2022 to 30th June 2022. In 241 children of either gender, (male and female) aged up to 15 years having structural or functional anomalies of the kidney and urinary tract or recurrent infection due to underlying kidney or urinary tract abnormalities were enrolled. Demographic and clinical characteristics along with laboratory parameters and etiological agents of complicated UTI were noted. Ultrasonography examination and dimercaptosuccinic acid (DMSA) renal scan (where indicated) were performed. Results: Of 241 children, 179 (74.3%) were male. The mean age was 3.08±3.63 years. Capillary refill time was prolonged in 78 (32.4%) children. Fever/chills, nausea/vomiting, urinary urgency, and dehydration were the most frequently noted clinical presentations reported in 232 (96.2%), 109 (45.2%), 91 (37.8%), and 89 (36.9%) children respectively. Ultrasonography findings were evident of bilateral moderative hydronephrosis in 60 (24.9%) children. E. coli followed by Pseudomonas and Klebsiella species were the most commonly found etiological agents noted in 98 (40.7%), 50 (20.7%), and 40 (16.6%) children respectively. Conclusion: The majority of the children with complicated UTIs were male. Fever/chills, nausea/vomiting, urinary urgency, and dehydration were the most frequently noted clinical presentations. The most commonly observed ultrasonography findings were bilateral moderative hydronephrosis