Proportion of urinary tract infection in neonatal sepsis

Background: Urinary tract infection (UTI) in neonates might be associated with bacteremia and congenital anomalies of the kidney and urinary tract (CAKUT), that in complicated situations can lead to renal parenchymal scarring and chronic kidney disease. Aim: To determine occurrence of UTI in neonatal sepsis. Methods: This cross sectional study was conducted on 500 term, extramural hospitalized neonates, suspected to have infection underwent, a detailed history, physical examination and a comprehensive sepsis workup. The diagnosis of neonatal UTI was based, on positive urine culture, obtained by suprapubic aspiration (SPA).  Results: Out of 500 neonates included in our study (324 boys and 176 girls), blood culture was positive in 84 (36.5%) neonates in early-onset sepsis group (n=230), while in late-onset sepsis group (n=270) blood culture was positive in130 (48.1%), p-value < 0.05. In both early-onset sepsis (EOS) and late-onset sepsis (LOS) groups, blood culture was found to be positive in a greater proportion of male (41.3%) than female (29.3%) patients, p-value <0.05.  The most common organism isolated from blood and urine culture was Klebsiella, followed by E-coli. Urine culture was positive in 34 (6.8%) patients, among whom 29 (85%) culture-positive cases were from the LOS group, a p-value of <0.05.  Conclusions: UTI is not uncommon among the hospitalized neonates, and UTI evaluation among septic neonates can prove beneficial for the prevention of long-term sequelae of neonatal UTI

Clinical Spectrum of Recurrent Urinary Tract Infections in Children: Recurrent Urinary Tract Infections in Children

Background and Aim: Urinary tract infection (UTI), is a common bacterial infection inpediatric group, can be easily diagnosed, but its recurrence can indicate underlying seriousanatomical defects of the urogenital tract, leading to acute morbidity and chronic medicalcondition, such as hypertension and renal insufficiency.Objective: To know the clinical spectrum and the frequency of recurrent UTI among childrenvisiting our hospital.Methods: This prospective study was conducted during the period from April 2020 to March2021, in the department of pediatrics and pediatric nephrology, Governmental MedicalCollege, Srinagar. All children aged between 6 months to 18 years presenting with a historyof recurrent urinary tract were included in the study. A detailed history, relevant clinicalexamination, and the ultrasonography of kidney ureters and bladder (USG KUB) followedby voiding cystourethrography (VCUG), were carried out and subsequently analyzed.Results: A total of 38 patients with recurrent UTI were evaluated during one year. Thecommonest age group was 6 months to 2 years (68%), with female preponderance (F: M3.2:1). Urine culture grew E. coli in 95% of patients, while USG abnormalities and thepresence of vesicoureteral reflux (VUR) on voiding cystourethrography (VCUG) were seenin 14 patients (36%).Conclusion: Recurrent UTI are common between 6 months to 2 years, and E coli is the mostcommon cause. Children with the past history of UTI seem more predisposed to have anotherE.coli-associated UTI