Diagnosis of urinary tract infection in infants and children with protein energy malnutrition

ABSTRACT

This study was carried out to assess the prevalence of urinary tract infection [UTI] in infants and children with protein energy malnutrition [PEM], to evaluate the reliability of dipstick tests for its diagnosis and to show the most common causative organisms and their sensitivity to antibiotics. Urine samples were aseptically obtained from 60 patients of both sexes who were suffering from different types of PEM and from 40 healthy age- and sex- matched infants and children as controls. Patients were selected from the pediatric outpatient clinic, Faculty of Medicine, Menoufia University. Urine samples were examined for 1]Dipstick [nitrite and leukocyte esterase] tests; 2] microscopic urine examination for leukocytes; 3] bacterial colony count and identification of the causative bacterial species; and 4] their antibiotic sensitivity were performed. Results showed increased prevalence of UTI among PEM patients [33.33%] than controls [7.5%]. Nitrite and leukocyte esterase tests had low sensitivity [35% and 55% respectively] and high specificity compared to urine analysis and culture. Enterobacteriaceae [E. coli, Klebsiella and Proteus] constituted 95% of the total isolates and they were highly sensitive to amikacin, tobramycin, gentamycin, and cefotaxime. In conclusion, it is important to look for UTI in PEM patients by demonstration of bacteriuria using culture which can not be replaced by screening dipstick tests