Hello doctor,
My 1.5 year old baby has suffered from UTI for the last 18 days. The culture report showed Klebsiella pneumoniae 100000 cfu/mL. Her doctor said Colistin is sensitive and she has been treated with Colistin and catheter IV for 15 days. But, her infection is not clearing and is going up and down. Today's report says pus cells 30 to 40, RBC 6 to 8 and epithelial cells 1 to 2. She had open ureteric bilateral surgery for grade 5 reflux on the right side and 4 on the left. Please guide us doctor.
Hello,
Welcome to icliniq.com.
Your baby has proven UTI - urinary tract infection with Klebsiella and is Colistin sensitive and unfortunately not responding. Also, she had bilateral reflux, which is prone to cause recurrent UTI.
The reason for persistent urine infection may be underlying anatomical defects (the reflux), resistance to Colistin or involvement of upper urinary tract (kidneys).
I recommend you to repeat urine cultures and get an ultrasound examination to look for any complications developed and whether any intervention is needed now, as during active infection other imaging studies are deferred.
I need to know, how many episodes of UTI she had earlier? Also, give me more details of reflux and surgery done and antibiotic prophylaxis being used.
Please continue her antibiotics. Thank you.
Revert back with the answers to the above questions to a paediatrician online --> https://www.icliniq.com/ask-a-doctor-online/paediatrician
Thank you doctor,
She had two UTIs earlier. The first one before 10 months and the second one before three months. She was treated with Micasin.
Hello,
Welcome back to icliniq.com.
- She has recurrent UTIs and this time it is persistent and not responding.
- Klebsiella UTI are sometimes resistant to Colistin.
- My suggestion if she is symptomatic are as follows:
- Repeat urine culture.
- Remove or change the catheter.
- Ultrasound of abdomen and urinary system.
- Consult urologist, if still no reason found.
For further information consult a paediatrician online --> https://www.icliniq.com/ask-a-doctor-online/paediatrician
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