Acute Nosocomial Urinary Tract Infection in Children

Bacteremia due to healthcare-associated urinary tract infections in children

BACKGROUND

Epidemiological data on secondary bacteremia associated with nosocomial urinary tract infections generally include adult patients with urinary catheters.

AIM

To evaluate the frequency and outcome of secondary bacteremia complicating healthcare-associated urinary tract infections.

MATERIAL AND METHODS

This study was conducted between May 2013 and December 2017 at the Dr. Behçet Uz Children's Hospital and included symptomatic nosocomial urinary tract infections. A total of 117 patients with positive blood cultures were enrolled in the study.

RESULTS

Six patients had bacteremia associated with nosocomial urinary tract infections yielding an incidence of 5.1%. The pathogens responsible for secondary bacteremia were: Klebsiella pneumonia in two patients, Enterococcus faecium in two patients, Klebsiella oxytoca in one patient, and Pseudomonas aeruginosa in one patient.

CONCLUSION

The incidence of bacteremia associated with nosocomial urinary tract infections was not different from bacteremia associated with community-acquired urinary tract infections, and was approximately 5%.

Study of nosocomial urinary tract infections in a pediatric intensive care unit

Nosocomial urinary tract infections (NUTI) are one of the commonest infections in a Pediatric Intensive Care Unit (PICU). This prospective study was conducted in PICU between January and December 2008 to study the incidence, organisms and risk factors for NUTI. A total of 287 consecutive patients with >48 h PICU stay and sterile admission urine culture, were enrolled and monitored for NUTI (defined as per CDC criteria 1988) till discharge or death. Patients with and without NUTI were compared with respect to demographics, PRISM scores, primary diagnosis, nutritional status and device utilization to identify risk factors. Outcome was defined as length of PICU stay and survival or death. There were 69 episodes of UTI in 60 (20.9%) patients; incidence being 18 episodes/1000 patient days. Candida (52.1%) and Enterococcus (13%) were commonest followed by Escherichia coli (11.6%) and Klebsiella pneumoniae (10.1%). Catheterization and duration of catheterization were the risk factors for NUTI (p < 0.001). The median length of PICU stay was significantly longer in NUTI group compared to non-NUTI group (19 vs. 8 days, p = 0.001). Mortality rates in both the groups were similar.