BACTERIURIA IN CHILDREN ATTENDING A PRIMARY HEALTH-CARE CLINIC - A PROSPECTIVE-STUDY OF CATHETER STREAM URINE SAMPLES

Urinary tract infection (UTI) in infancy and childhood has received sc ant attention at primary health care (PHC) level, rarely featuring as one of the common diseases. In a prospective study conducted at a PHC clinic, 16 of 94 children (17%) from whom urine was collected by stric t aseptic catheterization had bacteriuria (BU). Twelve of these had as sociated leucocyturia (> 5 WBC/HPF). The median age of those with BU w as 9 months (range 1-30 months). BU rarely occurred in isolation (6%), but was most often detected in association with acute respiratory inf ection (43%) and acute diarrhoea (19%). No association of BU with mild malnutrition was detected in the 50% of children who were underweight for age. Gram-negative pathogens accounted for 14 cases (87.5%). Thes e pathogens were resistant to commonly recommended antibiotics for UTI . Only five cases of BU returned for follow-up at 3 months; no abnorma lities were detected on repeat catheter urine samples, urinary tract u ltrasonography, voiding cystourethrogram and DMSA studies in them. Fro m these and other findings we conclude that BU is probably often prese nt in young children with common diseases attending PHC centres in dev eloping countries. Further studies are required to establish exactly t he role these pathogens play in the pathogenesis of UTI.