Risk factors for urinary tract infection in children with urinary urgency

Gondim, Rhaiana; Azevedo, Roberta Vasconcellos Menezes de; Braga, Ana Aparecida Nascimento Martinelli; Veiga, M.L.; Barroso, Ubirajara

doi:10.1590/s1677-5538.ibju.2017.0434

Cited by 22 publications

(16 citation statements)

References 18 publications

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“…The identification of these is critical as it may be very helpful in medical practice through better management. A few studies addressed the topic and the results have varied with regard to the setting [4][5][6][7]. For instance, Festo and colleagues found that factors including female gender, age <2 years, positive white blood cell microscopy, positive nitrite test, diarrhea and prolonged fever, were associated with higher risk for UTI in Tanzanian children [4].…”

Section: Introductionmentioning

confidence: 99%

“…For instance, Festo and colleagues found that factors including female gender, age <2 years, positive white blood cell microscopy, positive nitrite test, diarrhea and prolonged fever, were associated with higher risk for UTI in Tanzanian children [4]. More recently, it was found that female gender and infrequent voiding were increasing the risk for UTI in children and adolescents in Brazil [7].…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Urinary Tract Infection and Their Diagnostic Performances among Cameroonian Under-five

Motse¹,

Ngaba²,

Kojom³

et al. 2019

Journal of Microbiology and Infectious Diseases

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Objective: Urinary tract infection (UTIs) in child is a serious public health problem especially in developing countries. This study aimed at identifying factors associated with urinary tract infection and determining their diagnosis performances as well as resulting algorithms among Cameroonian under-five. Methods: A descriptive and analytical cross sectional study took place from May 2013 to March 2014 at Pediatrics Department of the Bonassama District hospital in the town of Douala. Urine samples were collected dependent on the age of children and its aptitude to micturate. Ten microliters (10 µL) of urine specimen were cultured at 37°C for 24-48 hours. In addition, sociodemographic, anthropometric, clinic and biological information of each child were documented. Results: The prevalence of UTI was 32.2% (129/400) which was mainly caused by Escherichia coli (41.1%). A total of four risk factors for UTI were found after adjustment for all pertinent characteristics of children. These included female gender (ARR= 0.55; p= 0.0046), presence of fever (ARR = 1.83; p= 0.0426), trouble urine (ARR = 1.36; p= 0.0063) and presence of nitrites in urine (ARR = 1.09; p= 0.0001). Presence of nitrites was the most discriminant parameter based on specificity (98.1%), positive predictive value (95.4%) and negative predictive value (90.1%). The diagnosis performances have gradually improved with the increasing number of parameters. Conclusion: This study reported four factors associated with increased risk for UTI. This also outlined that the presence of nitrites in urine had best diagnosis performances and different predictors-based clinical algorithms could be helpful especially in the identification of UTI-negative children.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of Urinary Tract Infection and Their Diagnostic Performances among Cameroonian Under-five

Motse¹,

Ngaba²,

Kojom³

et al. 2019

Journal of Microbiology and Infectious Diseases

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“…Since dysuria was the symptom found to be most associated with increased stress, this merits particular consideration. The causes of dysuria can be manifold, including urinary infections, urethritis, nonbacterial inflammation of the bladder or urethra, and kidney stones (17,18). There is no clinically demonstrable reason to believe that the patients evaluated in the present study would be included in any of these categories.…”

Section: Discussion Pmentioning

confidence: 93%

Association between stress and lower urinary tract symptoms in children and adolescents

et al. 2019

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Introduction: Lower urinary tract dysfunction (LUTD) is a common clinical condition. Emotional and behavioral issues are increasing among children and adolescents, with stress indicating diffi culties in personal and social functioning. This study evaluated whether urinary tract symptoms (LUTS) is associated with stress. Materials and Methods: A cross-sectional, analytical study with 6-14-year-old patients with LUTS and no anatomical/neurogenic urinary tract abnormalities was conducted using the Dysfunctional Voiding Scoring System, a psychological assessment and the Child Stress Scale. The overall stress score was analyzed in relation to the psychological assessment data. Answers to the seven specifi c DVSS urinary questions were compared with those for the four Child Stress Scale domains. Univariate and multivariate analyses were performed. The chi-square test and Pearson's correlation were used to determine associations. Signifi cance was defi ned as p <0.05. Results: Most children were male (56%). Mean age was 9.0±2.25 years. Stress was detected in 20 out of 98 patients (20.4%; 95% CI: 13-30%).Of these, 90% were born from unplanned pregnancies and 67% were upset about their disorder. All the Child Stress Scale domains were signifi cantly associated with urinary dysfunction, with dysuria being signifi cantly associated with all four domains. In the multivariate analysis, dysuria was the only symptom that remained associated with stress. Associations with stress strengthened as the frequency of dysuria increased: physical reactions (p <0.01), emotional reactions (p <0.05), psychological reactions with a depressive component (p <0.01) and psychophysiological reactions (p <0.05). Conclusion: Stress levels are higher in children and adolescents with LUTS who have more severe symptoms. Dysuria was the symptom most associated with stress, both in the physical reactions domain, in the psychological reactions domains with or without a depressive component and in the psychophysiological reactions domain.

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“…In girls, these usually consist of crossing their legs, with one knee over the other, pressing their genitals, walking on tiptoe and squatting. It has been reported that 73% of children with LUTD perform holding maneuvers (14).…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis and Management of Bladder Dysfunction in Neurologically Normal Children

2019

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Normal bladder and urethral sphincter development as well as neural/volitional control over bladder-sphincter function are essential steps for regular lower urinary tract function. These maturational sequences are clinically evident by the age of 5 years. However, in 17–22% of children, symptoms persist beyond that age, characterizing lower urinary tract dysfunction (LUTD). The clinical spectrum is wide and includes overactive bladder, voiding postponement, underactive bladder, infrequent voiding, extraordinary daytime only urinary frequency, vaginal reflux, bladder neck dysfunction, and giggle incontinence. LUTD may lead to vesicoureteral reflux and recurrent urinary tract infections, increasing the likelihood of renal scarring. LUTD is often associated with constipation and emotional/behavioral disorders such as anxiety, depression, aggressiveness, and social isolation, making diagnosis, and treatment imperative. Diagnosis of LUTD is essentially based on clinical history, investigation of bladder storage, voiding symptoms (urinary frequency, daytime incontinence, enuresis, urgency) and constipation. Dysfunctional Voiding Score System (DVSS) is a helpful tool. Physical examination focuses on the abdomen to investigate a distended bladder or palpable fecal mass, the lumbosacral spine, and reflex testing. Bladder diaries are important for recording urinary frequency and water balance, while uroflowmetry is used to assess voided volume, maximum flow, and curve patterns. Bladder ultrasonography to measure post-void residual urine volume and urodynamics are used as supplemental tests. Current first line treatment is urotherapy, a combination of behavioral measures to avoid postponing micturition, and a restricted diet for at least 2 months. Anticholinergics, β3 agonists and neuromodulation are alternative therapies to manage refractory overactive bladder. Cure rates, at around 40%, are considered satisfactory, with daytime symptoms improving in 32% of cases. Furthermore, children who are also constipated need treatment, preferentially with polyethylene glycol at doses of 1–1.5 g/kg in the 1st 3 days and 0.25–0.5 g/kg thereafter until the 2-month period of behavioral therapy is complete. If urotherapy fails in cases of dysfunctional voiding, the next step is biofeedback to teach the child how to relax the external urethral sphincter during micturition. Success rate is around 80%. Children with underactive bladder usually need a combination of clean intermittent catheterization, alpha-blockers, biofeedback and neuromodulation; however, cure rates are uncertain.

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Risk factors for urinary tract infection in children with urinary urgency

Cited by 22 publications

References 18 publications

Predictors of Urinary Tract Infection and Their Diagnostic Performances among Cameroonian Under-five

Predictors of Urinary Tract Infection and Their Diagnostic Performances among Cameroonian Under-five

Association between stress and lower urinary tract symptoms in children and adolescents

Diagnosis and Management of Bladder Dysfunction in Neurologically Normal Children

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