Abstract

Background: UTI in SAM prevalence rates range from 6% to 37% in developing countries. The most common bacterial isolates are Gram negative organisms. Due to increase in the magnitude of antibiotic resistance, there is a need to routinely investigate specific pathogens causing UTI and use effective antibiotics.
Methodology: It was a hospital based prospective study. All children who fulfilled WHO criteria for SAM, admitted at KIMS were included. Fresh urine samples were collected at admission and sent for urine microscopy and culture sensitivity. Urine dipstick for nitrites and leucocyte esterase was also done.
UTI was suspected when > 10 leucocytes/mm3 in an uncentrifuged sample or positive leukocyte esterase and nitrite test by dipstick was seen. UTI was further confirmed by positive urine culture.
Results: Of total 104 SAM children, prevalence of UTI was found to be 25.9%. 51.9% were females and 48.1% were males. In culture positive cases, mean age in years was 1.48 years +0.96.
70.4% of urine culture positive samples had >5 pus cells in the urine. Dipstick leucocyte esterase was highly sensitive in detecting UTI (81.5%). Combineddipstick leucocyte esterase and nitrite test was highly specific (100%). E. coli was the most common organism isolated (59.2%) followed by Klebsiella (14.8%). Most of the organisms isolated were sensitive to piperacillin tazobactam (59.2%). Most isolates were resistant to Ampicillin.
Conclusion: In our study, high prevalence of UTI (25.9%) was seen. Bedside dipstick tests can be used effectively to detect UTI. Commonest organisms isolated were Gram negative bacteria and showed good sensitivity to piperacillin tazobactam. Early detection and treatment of UTI in SAM children is necessary to prevent long term complications.