E. coli versus Non-E. coli Urinary Tract Infections in Children: A Study from a Large Tertiary Care Center in Saudi Arabia

BACKGROUND: While Escherichia coli (E. coli) is the most common uropathogen implicated in urinary tract infections (UTIs) in children, some studies have found that there are different characteristics between different uropathogens in children. The aim of this study was to compare E. coli and non-E. coli UTIs in children with respect to their demographic data, predisposing factors, and imaging results. METHODOLOGY: A retrospective chart review was done in children during their first admission with urine culture confirmed UTI in a tertiary care center. We divided patients into E. coli and non-E. coli groups according to urine culture results. RESULTS: Out of 202 children with their first admission for a culture-proven UTI, pathogens other than E. coli accounted for 24.3% of UTIs. Klebsiella pneumoniae was the most common non-E. coli pathogen, followed by Pseudomonas aeruginosa and Enterococcus species. Non-E. coli UTIs were significantly more common in male subjects, younger children, and children with a past history of UTI or who had received antibiotics prior to admission. In addition, higher rates of abnormalities on renal ultrasound and VCUG were found with non-E. coli organisms. CONCLUSION: There is a significant difference in demographic and imaging findings in children with non-E. coli UTIs. These findings may impact the work-up and treatment of UTIs in the pediatric population.