Clinical and etiological profile of urinary tract infections (UTI) in children with congenital anomalies of kidney and urinary tract (CAKUT)

Abstract

Objective: To determine the clinical and etiological profile of Urinary tract infections (UTI) in children with Congenital Anomalies of kidney and urinary tract (CAKUT) presenting at National Institute of Child Health (NICH) Karachi

Place and Duration of the study: This descriptive cross sectional study was conducted at Nephrology and Neonatology Departments of NICH from 1st January, 2022 to 30th June, 2022.

Methodology:  Patients aged up to 15 years having structural or functional anomalies of the kidney and urinary tract (CAKUT) who presented with UTI were enrolled. Demographic and clinical characteristics of patients were recorded and urine specimen were sent to laboratory for Urine detailed report and culture and sensitivity.  Results of culture and sensitivity testing including the pathogen and its antibiotic sensitivity profile were recorded.

Results: Total 87 children with CAKUT presented with UTI including 64 (73.6%) males. Common congenital anomalies in these patients were vesicoureteral reflux (VUR) in 28 (32.1%) patients followed by posterior urethral valve (PUV) in 28 (32.1%)   bilateral pelviureteric junction obstruction (PUJO) 11(12.6%). Fever/chills 84(96.6%), nausea/vomiting 39(44.8%), urinary urgency 33 (37.9%), dehydration 31 (35.6%) and abdominal pain 30 (34.5%) were the frequently noted clinical presentations in these patients. E. coli, Ps. aeruginosa and K. pneumonia were the commonly isolated etiological agents with a frequency of 35 (40.2%), 19 (21.8%) and 14 (16.09%) respectively.

Conclusion: Among CAKUT patients UTI was predominantly observed in male patients with PUV, VUR and PUJO. Patients mainly present with fever, nausea and urinary urgency with E. coli being the most common etiological agent.