Prevalence of urinary tract infection in children with cerebral palsy: Experience at tertiary care centre.

Abstract

Objective: To determine the prevalence of urinary tract infections, causative organisms and culture sensitivity pattern in children with CP. Study Design: Cross Sectional Descriptive. Setting: The Children Hospital and The Institute of Child Health Multan. Period: September 2020 to September 2021. Material & Methods: After consent from parents and ethical approval, 52 children diagnosed case of CP, 2-12 years, of both gender were enrolled. Demographic data and socioecononomical status was noted. Type of CP was ascertained. Complete urine examination was sent for microscopy and culture sensitivity. Results: Out of 52 children male were prominent with age range of 2-7 years (mean age ± SD, 5.8 years ± 3.27). Mostly children were malnourished, belonged to low socioeconomic status {73.1% (n=38)} and spastic quadriplegic type, {53.8% (n=28)}. UTI was significantly found in 73.1% (n=38) of CP children (p-value=0.002), predominantly in male (76.5%), of 2-7 years of age (66.7%), malnourished (66.6%), with low socioeconomic status (73.7%) and Spastic quadriplegic type (85.7%). No organisms were detected in 52.7% (n=20) of UTI positive children with predominantly E-coli 26.4% (n=10), and was found most susceptible to amikacin, gentamicin, imipenum and meropenum, while least susceptible to Nalidixic acid, Amoxicillin-clavulanic acid, Piperacillin-Tazobactum, cefotaxime and ceftriaxone. Other organisms were, Klebseila pneumonia in 10.1% (n=4), Enterobacter and Pseudomonas Aurigenosa in 5.4% (n=2) children each. Abdominal USG showed positive findings in 63.1% (n=24) children. 16 children detected thick walled urinary bladder, 2 fullness of pelvocalyceal system, 2 echogenic urinary bladder walls, and in 2 echogenic kidneys. Conclusion: UTI is common complication which can lead to renal compromise. So all the CP children must be properly screened and managed for UTI to minimize the complications. Appropriate antibiotic must be used to avoid the antibiotic resistance.