Urinary tract infections agents in malnourished children Original Article

Abstract

Aim: The aim of our study was to determine the frequency of urinary tract infection in children with PEM and the species of bacteria that cause urinary tract infection in children with protein energy malnutrition PEM and to compare with the control group with hout PEM Material and Method: In this study 79 children aged 3 months to 5 years who were diagnosed as PEM according to Gomez Classification were included Control group consisted of 66 children with positive urine culture in same age and sex Results: In 79 children with PEM urinary tract infection rate was found as 39 2 The most common isolated microorganism from urine cultures was Proteus spp 32 3 and the others were E coli 25 8 Staphylococcus spp 19 4 Klebsiella spp 9 7 Enterobacter spp 6 5 Pseudomonas spp 3 2 and Streptococcus spp 3 2 respectively In 66 control cases the most common isolated nbsp; microorganisms were E coli 54 5 Staphylococcus spp 18 2 and Proteus spp 13 6 While Proteus spp frequency in patients with PEM was significantly higher than control group E coli frequency in the former group was significantly lower than the later nbsp; p=0 03 and p= 0 008 respectively Conclusion: We want to emphasize that pathogens of urinary tract infection isolated from the children with PEM may be different from the pathogens isolated from the children without PEM Turk Arch Ped 2007; 42: 162 4 Key words: Malnutrition Protein energy malnutrition Urinary tract infection

Keywords

• -

Malnütrisyonlu çocuklarda görülen idrar yolu enfeksiyon etkenleri Orijinal Araştırma

Öz

Amaç: Çalışmamızda protein enerji malnütrisyonu PEM nbsp; olan çocuklarda idrar yolu enfeksiyonunun İYE sıklığının saptanması ve İYE’ye neden olan etkenlerin PEM olmayan aynı yaş ve cinsteki çocuklarla karşılaştırılması amaçlandı Gereç ve Yöntem: Gomez sınıflamasına göre PEM tanısı koyulan yaşları 3 ay 5 yıl arasında değişen 79 hasta çalışmaya alındı Kontrol grubu benzer yaş ve cinsiyette idrar kültürü pozitif olan 66 çocuktan oluşuyordu Bulgular: Protein enerji malnütrisyonu olan 79 çocukta İYE nbsp; 39 2 oranında tespit edildi İdrar kültüründe en sık üreyen etkenler sırası ile Proteus spp 32 3 E coli 25 8 Staphylococcus spp 19 4 Klebsiella spp 9 7 Enterobacter spp 6 5 Pseudomonas spp 3 2 Streptococcus spp 3 2 ’idi nbsp; Kontrol grubu olan 66 olgunun idrar kültüründe en sık saptanan ilk üç mikroorganizma sırasıyla E coli 54 5 Staphylococcus spp 18 2 ve Proteus spp 13 6 idi Protein enerji malnütrisyonu olan grupta Proteus spp sıklığı kontrol grubundan anlamlı oranda daha fazla E coli sıklığı ise kontrol grubundan anlamlı oranda daha azdı p=0 03 ve nbsp; p= 0 008 Çıkarımlar: Protein enerji malnütrisyonu olan çocuklardaki İYE etkenlerinin PEM olmayan çocuklardaki İYE etkenlerinden farklı olabileceğini vurgulamak istiyoruz Türk Ped Arş 2007; 42: 162 4 Anahtar kelimeler: İdrar yolu enfeksiyonu malnütrisyon protein enerji malnütrisyonu nbsp;

Anahtar Kelimeler

• -

Kaynakça

1. Kala UK, Jacobs DW. Evaluation of urinary tract infection in mal- nourished black children. Ann Trop Paediatr 1992; 12: 75-81.
2. Banapurmath CR, Jayamony S. Prevalence of urinary tract in- fection in severely malnourished preschool children. Indian Pe- diatr 1994; 31: 679-82.
3. Reed RP, Wegerhoff FO. Urinary tract infection in malnourished rural African children. Ann Trop Paediatr 1995; 15: 21-6.
4. Hellerstein S. Recurrent urinary tract infections in children. Pedi- atr Infect Dis 1982; 1: 271-81.
5. Stark H. Urinary tract infections in girls: the cost-effectiveness of currently recommended investigative routines. Pediatr Nephrol 1997; 11: 174-7.
6. Kunin CM. Epidemiology and natural history of urinary tract in- fection in school age children. Pediatr Clin North Am 1971; 18: 509-28.
7. Welch TR, Forbes PA, Drummond KN, Nogrady MB. Recurrent urinary tract infection in girls. Group with lower tract findings and a benign course. Arch Dis Child 1976; 51: 114-9.
8. Lohr JA. Group B streptococcal urinary tract infections. Pediatr Infect Dis J 1990; 9: 150-1.

9. Mufson MA, Belshe RB. A review of adenoviruses in the etiolo- gy of acute hemorrhagic cystitis. J Urol 1976; 115: 191-4.
10. Caksen H, Cesur Y, Uner A, et al. Urinary tract infection and an- tibiotic susceptibility in malnourished children. Int Urol Nephrol 2000; 32: 245-7.
11. Shimeles D, Lulseged S. Clinical profile and pattern of infection in Ethiopian children with severe protein-energy malnutrition. East Afr Med J 1994; 71: 264-7.
12. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young child- ren. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Pediat- rics 1999; 103: 843-52.
13. Rushton HG. Urinary tract infections in children. Epidemiology, evaluation, and management. Pediatr Clin North Am 1997; 44: 1133-69.
14. Hallett RJ, Pead L, Maskell R. Urinary infection in boys. A three- year prospective study. Lancet 1976; 2: 1107-10.
15. Schlager TA. Urinary tract infections in children younger than 5 years of age: epidemiology, diagnosis, treatment, outcomes and prevention. Paediatr Drugs 2001; 3: 219-27.