MICROBIOLOGICAL PROFILE OF URINARY TRACT INFECTION IN CHILDREN WITH VESICOURETERIC REFLUX AND COMPARISON OF E COLI AND NON-E COLI INFECTIONS.

Background: The urinary tract is a common site of infection in the paediatric population. Vesicouretric reflux (VUR) refers to the retrograde passage of urine from the bladder into the ureter. A high incidence of VUR is reported in patients undergoing evaluation for UTI. The aetiology of paediatric UTI and the antibiotic susceptibility of urinary pathogens in both the community and hospitals have been changing, and drug resistance has become a major problem. With this background, the present study was conducted to observe the profile of the paediatric UTI, to find out the bacterial pathogens involved and their antimicrobial susceptibility pattern in patients with VUR and consecutive renal scarring in these patients at a tertiary care centre in North India. Material and Method: All patients from 0-15 years of age diagnosed with urinary tract infection and vesicoureteral reflux attending the OPD and admitted in the hospital were included in the study. Urine was inoculated on Hicrome agar using a calibrated loop the plates were examined after 24 hours for colony morphology, significant colony count, and their characteristics. Patients underwent VCUG and DMSA scan when indicated. Results: Overall males were more affected than females. E Coli was the commonest organism grown on culture. Quinolones, cotrimoxazole and amoxicillin were among the less effective drugs where as nitrofurantoin, aminoglycosides were highly effective drugs. Renal scars were more commonly seen in higher grade of reflux whereas there was no difference in scarring in E Coli vs Non E Coli infections. Conclusion: Cotrimoxazole should not be used for antimicrobial prophylaxis where as nitrofurantoin is a better option for prophylaxis. Aminoglycosides can be used as empirical therapy till the results of antimicrobial sensitivity are available. Renal scars are seen more often in higher grades of vesicoureteric reflux and thus need to be treated aggressively