Clinical features of community-acquired Pseudomonas aeruginosa urinary tract infections in children

Abstract

This retrospective chart review sought to determine clinical, radiological, and gender-associated characteristics of community-acquired Pseudomonas aeruginosa (PA) urinary tract infections (UTIs) among children admitted to two medical centers. The records of 73 children with community-acquired PA UTIs were compared with records of 109 children with community-acquired UTIs caused by other pathogens. The mean age of both groups was similar. The PA UTI group included more boys. Features significantly more common in the PA UTI group were the number of patients who had undergone urinary tract surgery, patients with skeletal and/or neurological malformation, patients with >1 previous episode of UTI, patients on prophylactic antibiotic treatment on admission, and patients with pathological renal ultrasound and voiding cystourethrography (VCUG) findings. Multivariate logistic regression analysis revealed the following to be associated with PA UTI: >1 episode of UTI in the past [odds ratio (OR) = 35.5; 95% confidence interval (CI) 11.6-108.7], previous urinary tract surgery (OR = 34.1; 95% CI 7.00-166.2), and pathological VCUG results (OR = 2.62; 95% CI 0.96-7.15). In conclusion, PA UTI is associated with >1 previous UTI, urinary tract abnormalities, and past urinary tract surgery. We recommend that when UTI is suspected in children with these risk factors, a thorough radiologic investigation, including a VCUG, should be considered.

Antimicrobial Susceptibilities and Clinical Characterization of <b><i>Pseudomonas aeruginosa</i></b> Isolates from Urinary Tract Infections

“…Female patients were reported to have a higher prevalence of UTI (60.5% female vs. 39.5% male), which is consistent with the current knowledge that anatomical and physical factors, such as a shorter urethra, predispose women to UTI [17,18]. As found in previous studies, most of the patients in the P. aeruginosa group were male [16,19,20]. Additionally, the patients with P. aeruginosa infections had higher rates of urinary tract catheter and urinary tract operation, suggesting that the P. aeruginosa UTIs were not due to preexisting diseases.…”

Guidelines for urinary tract infections and antenatal hydronephrosis should be gender specific

“…While Escherichia coli prevalence decreases, Pseudomonas and Proteus spp become more prominent in recurrent infections. These findings are supported by previous studies .…”

Local Inflammation Induces Complement Crosstalk Which Amplifies the Antimicrobial Response

“…This novel antimicrobial mechanism is particularly effective against the P. aeruginosa , an opportunistic pathogen which causes mortality in critically ill and immuno-compromised patients [39]. Both the immunoevasive nature [54] of P. aeruginosa as well as its acquisition of multi-drug resistance [55] makes elimination of this microorganism a particular challenge.…”

“…Its acquisition of multiple antibiobitic-resistance factors [37],[38] poses a grave challenge to drug manufacturers and patient healthcare management. Here, we found that P. aeruginosa , which thrives in local infections of the urinary tract [39], soft tissue [40], bone and joint [41], was effectively killed within 30 min in a typical infection-inflammation condition in contrast to normal condition. To determine the underlying mechanisms of the antimicrobial action, the interaction between ficolins and CRP was extensively characterized.…”