Utility of enhanced quantitative urine culture technique for isolation of uro-pathogens in children.

Background: Urinary tract infections (UTIs) are the most common bacterial infection worldwide. Symptoms of UTI in children is vague & non-specific and mostly underdiagnosed Standard urine culture (SUC) is the gold standard for detecting uropathogens but the clinical correlation and its implication in initiating antimicrobial therapy continue to be a question for decision-making. Enhanced quantitative urine culture (EQUC) was developed to overcome these limitations. However, its utility to diagnose paediatric UTI has not been well explored, necessitating the need for new diagnostic methods. The study was conducted to evaluate the utility of EQUC for isolation of bacterial uropathogens in children.

Method: A prospective observation study was conducted and urine samples were collected and processed using both SUC and EQUC techniques. Microbial identification was performed using phenotypic characteristics and biochemical tests. VITEK 2 SYSTEM was used for identification and antimicrobial susceptibility testing whenever required.

Results: A total of 156 samples were collected from 84 patients and subjected to SUC and EQUC techniques. SUC identified 50 positive samples (32.05%), while EQUC identified 87 positive samples (55.7%). EQUC recovered 25% more organisms compared to SUC. Escherichia coli was the most common organism isolated in both the techniques. Management of patients considering EQUC results showed better recovery in all age groups especially for midstream urine.

Conclusion: The EQUC technique demonstrated higher recovery rates of uro-pathogens compared to the SUC, making it a valuable tool for diagnosing paediatric UTIs.