Prevalence of Urinary Tract Infection among Children attending Khartoum State Hospitals

Urinary tract infection is the most common serious bacterial infection causing illness in infants and children; it accounted for 10% of all febrile illnesses in children. It is more common in preterm babies (4-25%) than term ones (1%). In early life, it is more common in males than females then decline rapidly in the prepubertal life girls experienced more episodes  of UTIs than males, 8% compared to 20% respectively. The prevalence rates of UTI varied by age, gender, race, and circumcision status. Uncircumcised male infants less than 3 months of age and females less than 12 months of age had the highest baseline prevalence of UTI. This study conducted to determine prevalence of Urinary Tract Infection among Children attending Khartoum State hospitals. Cross-sectional prevalence study of 200 samples of mid-stream urine was collected from children attending three hospitals in Khartoum state. A demographic questionnaire were collected and urine samples were tested microbiologically by standard procedures. Kirby-Bauer technique was performed for testing commonly used antimicrobial agents by measuring susceptibility of the isolated organisms according to NCCLS guidelines. The growth of clinical isolates ≥10⁴ CFU/ml of urine samples represent significant bacteriuria was representing 58 (29%), for insignificant growth 19 (9.5%) and 123 (61.5%) no bacterial growth. Among children age (2-16 years) presenting with sign and symptoms of UTI, the overall prevalence in females 33.6% [38/113] and among males 23% [20/87]; while 17 circumcised male and 3 uncircumcised male had UTI. The most common uropathogens isolated were Escherichia coli (44.8%), Staphylococcus aureus and Klebsiella Spp (20.7%) for each and Enterococcus facials (6.9%). The susceptibility to antimicrobial was high for impenem (96.56%), amikacin (94.8%), gentamycin and nitrofurontoin (75.8% & 74.1%) respectively but low for cefotaxime 29.31%, ceftazidime (24.13%), Amoxyclave and tetracycline (13.8%) each. A high prevalence rate of UTI among children shows a notable correlation between microbiology findings and clinically-suspected UTI in some Khartoum state district hospitals. Circumcision among boy tend to decrease the incidence of UTI, the rate of UTI in uncircumcised boys are more prone to UTI. The antibiotics commonly used in UTIs are less effective by 55.17% e.g.: ciprofloxacin. Since the present study was a short-time study, regular monitoring is required to establish reliable information about resistance pattern of urinary pathogens among children for optimal empirical therapy.