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Contribution of urinary tract infection to the burden of febrile illnesses in young children in rural Kenya.

dc.contributor.author Armstrong, J
dc.contributor.author Holland, Thomas
dc.contributor.author Masika, WG
dc.contributor.author O'Meara, WP
dc.coverage.spatial United States
dc.date.accessioned 2017-11-01T13:13:59Z
dc.date.available 2017-11-01T13:13:59Z
dc.date.issued 2017
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/28323886
dc.identifier PONE-D-16-30215
dc.identifier.uri https://hdl.handle.net/10161/15688
dc.description.abstract INTRODUCTION: The clinical features of UTI in young children may not localize to the urinary tract and closely resemble other febrile illnesses. In malaria endemic areas, a child presenting with fever is often treated presumptively for malaria without investigation for UTI. Delayed or inadequate treatment of UTI increases the risk of bacteremia and renal scarring in young children and subsequently complications as hypertension and end stage renal disease in adulthood. METHODS: A cross-sectional study was carried out in a hospital in western Kenya. Inpatients and outpatients 2 months to five years with axillary temperature ≥37.5°C and no antibiotic use in the previous week were enrolled between September 2012 and April 2013. Urine dipstick tests, microscopy, and cultures were done and susceptibility patterns to commonly prescribed antibiotics established. UTI was defined as presence of pyuria (a positive urine dipstick or microscopy test) plus a positive urine culture. RESULTS: A total of 260 subjects were recruited; 45.8% were female and the median age was 25months (IQR: 13, 43.5). The overall prevalence of UTI was 11.9%. Inpatients had a higher prevalence compared to outpatients (17.9% v 7.8%, p = 0.027). UTI co-existed with malaria but the association was not significant (OR 0.80, p = 0.570). The most common organisms isolated were Escherichia coli (64.5%) and Staphylococcus aureus (12.9%) and were sensitive to ciproflaxin, cefuroxime, ceftriaxone, gentamycin and nitrofurantoin but largely resistant to more commonly used antibiotics such as ampicillin (0%), amoxicillin (16.7%), cotrimoxazole (16.7%) and amoxicillin-clavulinate (25%). CONCLUSION: Our study demonstrates UTI contributes significantly to the burden of febrile illness in young children and often co-exists with other infections. Multi-drug resistant organisms are common therefore choice of antimicrobial therapy should be based on local sensitivity pattern.
dc.language eng
dc.relation.ispartof PLoS One
dc.relation.isversionof 10.1371/journal.pone.0174199
dc.subject Bacteriuria
dc.subject Child, Preschool
dc.subject Cross-Sectional Studies
dc.subject Escherichia coli
dc.subject Female
dc.subject Fever
dc.subject Humans
dc.subject Infant
dc.subject Kenya
dc.subject Malaria
dc.subject Male
dc.subject Microbial Sensitivity Tests
dc.subject Staphylococcus aureus
dc.subject Urinary Tract Infections
dc.title Contribution of urinary tract infection to the burden of febrile illnesses in young children in rural Kenya.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/28323886
pubs.begin-page e0174199
pubs.issue 3
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Infectious Diseases
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 12
dc.identifier.eissn 1932-6203


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