Study of Urinary Tract Infections in Infants with Acute Fever in North Karnataka

Background: Urinary tract infection (UTI) is identified by the presence of both pyuria and at least 50,000 colo-nies/ml of a single uropathogenic organism in an appropriately collected specimen of urine. In infants, the only presentation of UTI shows non-specific signs such as irritability, feeding poorly, vomiting, sleeping more, or showing signs of jaundice. Method: 60 infants admitted for fever were studied. Symptoms were increased frequency of micturition, crying while voiding, and pyuria. General and systemic examinations were done to rule them out. Phimosis, vulvular synechiae, and suprapubic mass, renal mass, dysmorphic features, and associated congenital anomalies were observed. A provisional diagnosis was done mainly based on signs and symptoms. Routine urine analysis, mi-croscopic analysis of urine, and urine culture were carried out. Positive patients were further examined by USG and MCU, and a differential diagnosis was also done to confirm the UTI. Results: 60 (100%) fever, 23 (38.3%) vomiting, 34 (56.61%) irritability, 42 (70%) failure to thrive, 8 (13.31%) jaundice, 13 (21.1%) convulsion, 18 (30%) gastroenteritis, 15 (25.7%) fever without focus, 8 (13.3%) URTI, 11 (18.3%) UTI, 5 (8.33%) septicaemia, and 3 (3%) bronchitis. The highest antibiotic sensitivity of the organism growing in the urine culture sample was 54 (90%) amikacin, followed by 43 (71.6%) laxacin, 35 (58.3%) nor-floxacin, 25 (41.6%) gentamicin, and the least was 6 (10%) ceftriaxone. Conclusion: Urine culture should be an essential part of the evaluation of febrile infants with no longer signs for proper diagnosing of UTL.