Distribution and determinants associated with febrile urinary tract infection In infants.

Abstract

INTRODUCTION:-

Urinary tract infections (UTIs) are a common bacterial infection in children, affecting around 7.8% of those under 19 years with urinary symptoms or fever. The prevalence of UTIs varies by age, sex, and circumcision status. Boys are more frequently affected in the first year of life (3.7%) compared to girls (2%), often signaling congenital anomalies of the kidneys and urinary tract (CAKUT). After infancy, girls experience a higher incidence due to anatomical factors such as a shorter urethra. Escherichia coli accounts for 80% of pediatric UTIs, and other bacteria like Enterococcus, Proteus, and Klebsiella are also implicated. Diagnosis is challenging in younger children, where fever and nonspecific symptoms often prevail. This study aims to identify the distribution and determinants of febrile UTI in children aged 1–12 months.

Aim & Objectives:

This study aimed to analyze the distribution and risk factors associated with febrile urinary tract infections (UTIs) in children aged 1 to 12 months. The objective was to explore the prevalence of UTIs across this age group and examine key determinants influencing their occurrence.

Materials & Methods:

A total of 564 infants were included in the study, which was conducted in the Department of Pediatrics at Sree Balaji Medical College and Hospital. Informed consent was obtained from the parents or guardians. Data were collected through interviews using a structured questionnaire, covering demographic information, medical history, symptoms, and breastfeeding patterns. Anthropometric measurements were recorded, and urine samples were analyzed. Statistical analysis was conducted using SPSS version 27, employing the Chi-square test and odds ratio with a significance threshold of p < 0.05.

Results:
UTIs were more prevalent among infants younger than six months (OR = 2.33, 95% CI = 1.16-4.65, p = 0.016), while no significant association was found with gender or socioeconomic status. Escherichia coli was the predominant pathogen (59.5%). Poor weight gain (OR = 2.84, p = 0.0039) and the presence of anatomical abnormalities such as vesicoureteral reflux (VUR) (OR = 4.42, p = 0.0002) were significantly associated with UTIs. Breastfeeding had a protective effect (OR = 0.09, p = 0.0001), while tight clothing and uncircumcised status increased UTI risk. Other indicators, including poor feeding and foul-smelling urine, were also significant.

Conclusion:
Infants younger than six months had a higher risk of developing febrile UTIs. While gender and socioeconomic status were not significantly related to UTI occurrence, breastfeeding, circumcision, and anatomical abnormalities played crucial roles in determining the risk. Proper infant care, including breastfeeding and addressing anatomical issues, could reduce UTI incidence in this population