Pediatric Urinary Tract Infection as a Cause of Outpatient Clinic Visits in Southern Ethiopia A Cross Sectional Study

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Enkosilassie Mitiku
Anteneh Amsalu
Birkneh Tilahun Tadesse


BACKGROUND: Failure to timely diagnose and treat urinarytract infections is associated with grave long term consequences.The objectives of this study included assessing the proportion andpredictors of Urinary Tract Infection (UTI) as a cause of pediatricoutpatient department (OPD) visits and determining commonuropathogens with antimicrobial susceptibility pattern.METHODS: A cross sectional study was conducted from May toSeptember 2015 among children of less than 15 years old at atertiary center in Hawassa, Ethiopia. Children who fulfilledpredefined eligibility criteria were recruited to undergo urineculture and urine analysis.RESULTS: A total of 863 children visited the OPD during the studyperiod among which 269(31.2%) fulfilled the predefined eligibilitycriteria. Urine culture was positive for 74/269(27.5%) of theclinically suspected children. Male uncircumcision (adjusted oddsratio (aOR) 3.70; 95% CI 1.34-10.16) and under nutrition (aOR5.41; 95%CI 2.64-11.07) were independent predictors of culturepositivity. More than 5 WBC per high power field (aOR 4.7, 95% CI1.8-12.7) on microscopy, urine PH > 5.0 (aOR 2.6, 95%CI 1.2-5.8),and positive leukocyte esterase (aOR 9.9, 95%CI 4.1-25.7)independently predicted positive growth on urine culture.Escherichia coli (34/74, 45.9%) and Klebsiella spp (18/74, 24.3%)were the most frequent isolates. High resistance was noted againstamoxicillin (70.6%) and cotrimoxazole (97.1%) by E. coli.CONCLUSION: UTI accounted for a tenth of total OPD visits.Commonly used first line antibiotics showed high level resistance tocommon etiologies of UTI. UTI should be suspected in febrilechildren, and antibiograms should be done to tailor prescription ofantibiotics.

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Original Article
Author Biographies

Enkosilassie Mitiku, Hawassa,Ethiopia

Department of Medical Microbiology Laboratory,

HawassaUniversityComprehensiveSpecialized Hospital,

Anteneh Amsalu, Hawassa, Ethiopia

DepartmentofMedicalMicrobiology Laboratory, HawassaUniversityComprehensiveSpecialized Hospital, Hawassa,Ethiopia

Birkneh Tilahun Tadesse, Hawassa University, Ethiopia

College of Medicine and Health
Sciences, Department of Pediatrics