Urinary tract infections in children with cancer and febrile neutropenia - single center experience

Background/Aim. Urinary tract infections (UTI) in children with febrile neutropenia (FN) after receiving chemotherapy could be followed by atypical symptoms and signs of UTI. Absence of routine sampling of urine culture for analysis could lead to undiagnosed disease and inadequate treatment of these patients. The aim of the study was to indicate the importance of sampling of urinoculture in children who have developed febrile neutropenia and to point out the most probable causative agents of UTI in children with FN and antibiotic sensitivity/resistance of the isolated strains. Methods. During a five-year observation period, 40 UTIs were registered in 30 patients with FN. In the study group of patients with FN the number of UTI, the number of recurrent UTI, isolated pathogens, their sensitivity to antibiotics, characteristics of urine sediment, the presence of localized symptoms of urinary tract infection and presence of urosepsis were analyzed. The obtained results were compared with the control group which consisted of children who were healthy prior to hospitalization due to febrile urinary infection. Results. When compared to the control group, significant differences in the presence of symptoms of urinary tract infection and urine sediment findings in patients with febrile neutropenia were observed. Higher percentage of resistant strains of Escherichia coli were isolated from urine culture of cancer patients with FN was noted when compared to the control group. Three UTI cases were followed by urosepsis. Conclusion. Urine culture findings are important not only in establishing the diagnosis of UTI and detecting multi-resistant bacterial strains, but also in appropriate antibiotic choice and selecting subgroup of patients with recurrent UTI who require further monitoring and detecting potential complications in a timely manner.