Risk factors for acute and recurrent urinary tract infection in children

ABSTRACT

Urinary tract infection [UTI] is a common problem in infants and children. This infection is mostly ascending Recurrent U.T.I. is mainly caused by bad hygiene and poor health education, and its incidence increased with enuretic children. Cases with episodes of U.T.I. must be followed up by urine culture monthly because may have a new episode without symptoms. The aim of this work it to identify the possible risk factors that may lead to acute and recurrent U.T.I. among children. This study included 100 children suffered from U.T.I. aged from 2-14 years and attended our pediatric clinic. No 29 cases of them had urinary symptoms, 28 cases were a symptomatic and proved to have infections during routine urine investigations, and 43 cases had one episode of U.T.I. and came for follow up which was monthly based on urine culture and during follow up they had recurrent U.T.I. These patients subjected to urine analysis and culture, stool analysis, renal function test, complete blood picture, erythrocyte sedimentation rate, C-reactive protein and ultra sonography for abdomen and pelvis to detect any abnormality, stones and to measure post voided bladder capacity. Our study showed no sex difference in U.T.I. 18% of boys were uncircumcised;. 21% with postponement of the start of potty-training, 61% had pinworm infection, 2% had bladder stones, 3% had bilharzial ova and 16% had enuresis. Urine cultures were positive for E-coli, Klebsiella, Staph. Aureus and Staph. Epidermidis. No, mixed infection was found. With measurement of post-voided bladder volume, we found 11% had voiding dysfuctions. These results proved the presence of multi-factorial risk factors for occurrence of U.T.I. U.T.I. is mainly affected by had hygiene, poor health education and negligence from doctors to follow up patients if they have no symptoms. We recommend routine follow up for U.T.I. cases based on urine culture to enhance early detection of recurrence and early proper treatment. Pediatricians should take urinary symptoms very seriously into account and should do routine wine workup to detect asymptomatic U.T.I