Urinary tract infections in children.

From January 1981 to December 1987, 346 children with urinary tract infections, proved by urine culture, were admitted to the Department of Pediatrics, Mackay Memorial Hospital. The ratio of male to female was 3.0 in children below 2 years, and 0.8 in children above 2 years, of age. The urine specimens were collected from suprapubic punctures in 281 cases (81.2%). Fever was the most common clinical manifestation. In children below two years old, other common symptoms and signs were body weight loss or poor gain, feeding problems, diarrhea, irritability, jaundice, and abdominal distension. In older children, urinary frequency, dysuria, enuresis, loin and abdominal pain were frequently found. Hematuria and edema were occasionally noted in all age groups. Microscopic examination of 329 centrifuged urine specimens revealed: 256 cases (77.8%) had more than 5 leukocytes per high power field, 233 cases (70.8%) had more than 10 leukocytes. Three hundred and seventy positive urine cultures were obtained from these patients. E. coli was isolated in 273 cases (73.6%), followed by Klebsiella spp., 34 cases (9.2%); Proteus spp., 27 cases (7.3%); Enterococcus, 21 cases (5.7%); Enterobacter spp., 9 cases (2.4%); Pseudomonas aeruginosa, 8 cases (2.2%); Citrobacter spp., 7 cases (1.9%); Morganella morganii, 6 cases (1.6%); Acinetobacter spp., 6 cases (1.6%); etc. Candida albicans was isolated from three patients. Two organisms were isolated in 26 cultures; 3 organisms, in 3, and 4 in 1.