Epidemiological and bacteriological aspects of children suspected of having febrile urinary tract infections in Kisantu and Kimpese in the province of Kongo-Central in the Democratic Republic of the Congo

Abstract

Introduction

Febrile urinary tract infections (FUTIs) are among the most common bacterial infections in children and represent a major cause of paediatric morbidity worldwide due to their clinical polymorphism, severity, and potential consequences on renal function.

Purpose

To evaluate the epidemiological characteristics of FUTIs in suspected children and to identify bacteria isolated from blood cultures performed in Kisantu and Kimpese in the Democratic Republic of Congo.

Methods

A descriptive, cross-sectional study was conducted using retrospective data collected between January 2018 and December 2022 in Kongo-Central Province, at Saint Luc Hospital (HSL) in Kisantu and the Evangelical Medical Institute (IME) in Kimpese. A convenience sample of 171 children who met the inclusion criteria was selected. Statistical analyses were performed using R version 4.4.2. Proportion comparisons were made using Pearson’s chi-square test, with a 95% confidence interval and a significance level set at p < 0.05.

Results

Among the 171 children suspected of having a UTI, 161 (94.2%) were from HSL, of whom 39 (24.2%) had a positive blood culture, and 10 (5.8%) were from IME, of whom 2 (20%) were positive, giving an overall prevalence of 23.9%. The most represented age group was 0–23 months (31.0%), with girls accounting for 47.4% (95% CI: 39.9–54.9) and an overall sex ratio of 1.11. Salmonella sp. was the most frequently isolated bacterium (36.6%), with a slight male predominance, while Escherichia coli was significantly more frequent in girls (19.5%; χ² = 6.79, p = 0.009). By age group, Salmonella sp. predominated in children aged 24–59 months, whereas E. coli predominated in the 120–204-month age group.

Conclusion

FUTI mainly affects very young children, with an overall balanced gender distribution. Salmonella sp. and E. coli are the most common bacterial pathogens, with variations according to age and gender. These findings provide essential local data to guide diagnostic and therapeutic decisions in paediatrics and highlight the need for further large-scale, longitudinal studies.