First urinary tract infections in children: the role of the risk factors proposed by the Italian recommendations

Alberici, Irene; Manna, Angela La; Pennesi, Marco; Starc, Meta; Scozzola, Floriana; Nicolini, Giangiacomo; Toffolo, Antonella; Marra, Giuseppina; Chimenz, Roberto; Sica, Felice; Maringhini, Silvio; Monasta, Lorenzo; Montini, Giovanni

doi:10.1111/apa.14506

Cited by 26 publications

(9 citation statements)

References 21 publications

(29 reference statements)

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“…In another study, Alberici et al. evaluated the risk factors proposed by the Italian guidelines for the first febrile UTIs in children. They report that only the presence of pathogens other than Escheria coli significantly predicted reflux and that cystography could be postponed in children with no risk factors.…”

Section: Vitamin D Deficiency and Microbial Peptides In Urinary Tractsupporting

confidence: 94%

“…Georgieva et al(9) report that first-time urinary tract infections (UTIs) in girls were associated with low vitamin D levels, but not with low levels of antimicrobial peptides. In another study, Alberici et al(10) evaluated the risk factors proposed by the Italian guidelines for the first febrile UTIs in children. They report that only the presence of pathogens other than Escheria coli significantly predicted reflux and that cystography could be postponed in children with no risk factors.…”

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confidence: 99%

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Käll¹,

Lagercrantz²

2019

Acta Paediatrica

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Many seemingly healthy children show signs of metabolic syndromeMore than a quarter of otherwise healthy six-year-old Swedish children may have metabolic risk factors that increase their risk for cardiovascular disease. This finding comes from a longitudinal study that was conducted in Halland, south-west Sweden, by Kjellberg et al. (1). They found that 26% of the 212 children in the study had abnormal metabolic profiles, including insulin resistance. Jan Gustafsson (2) comments on the findings.

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Section: Vitamin D Deficiency and Microbial Peptides In Urinary Tractsupporting

confidence: 94%

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confidence: 99%

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Käll¹,

Lagercrantz²

2019

Acta Paediatrica

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“…In this study, non‐ E. coli infection was the most closely associated factor with clinically significant urological anomalies. Many studies report that non‐ E. coli infection is one of the risk factors for renal malformations and scarring, 17,19,22–24 and one bacterial attachment study supports it 25 . The 2007 NICE guideline and the 2019 Italian guidelines demonstrate that VCUG should be performed for non‐ E. coli infections 5,8 .…”

Section: Discussionmentioning

confidence: 99%

Predicting factors of clinically significant urological anomalies after initial urinary tract infection among 2‐ to 24‐month‐old children

Banno

Sugiyama

2022

Acta Paediatrica

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Aim: To find more effective criteria to identify clinically significant urological anomalies after initial urinary tract infection among children. Methods:Children aged 2-24 months with an initial urinary tract infection were consecutively recruited in a Japanese hospital from 2013 to 2019. Voiding cystourethrography, 99mTc dimercaptosuccinic acid scan and ultrasound were intended to perform for all cases. Clinically significant urological anomalies were defined as high-grade vesicoureteral reflux, obstructive and abnormal urinary tract lesions, need for surgical intervention, renal hypoplasia and scarring. Using classification and regression tree analysis, we sought the associated factors. We developed new criteria with these factors, retrospectively applied them to the original data, and calculated the sensitivity and specificity.Results: One hundred sixty-seven patients were eligible, and 39 had clinically significant urological anomalies. Classification and regression tree analysis showed that the associated factors were non-E. coli infections, serum creatinine levels and ultrasound abnormalities. When the gold standards were performed on children with non-E. coli infections or serum creatinine levels ≥0.21 mg/dl, sensitivity and specificity were 0.82 and 0.68, respectively. Conclusion:The criteria including non-E. coli infections and high-normal or higher serum creatinine levels may efficiently predict clinically significant urological anomalies after initial urinary tract infections.

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“… First febrile UTI in children less than three years old Children at any age with one or more of the following: Recurrent UTIs (see definition) UTI and family history of VUR in first-degree relatives [ 46 ]. Febrile UTI caused by an organism other than E. coli [ 23 , 25 ].…”

Section: Imaging Studiesmentioning

confidence: 99%

“… Recurrent UTI Complicated UTI (see definition) Abnormalities in RBUS results (e.g., hydronephrosis, renal scarring, or any other findings that suggest either high-grade VUR or obstructive uropathy) Febrile UTI caused by an organism other than E. coli. 23,25,41 Child with UTI and family history of VUR in first-degree relatives [ 46 ]. …”

Section: Imaging Studiesmentioning

confidence: 99%

Diagnosis and management of community-acquired urinary tract infection in infants and children

Albarrak

Alzomor

Almaghrabi

et al. 2021

International Journal of Pediatrics and Adolescent Medicine

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Urinary tract infection (UTI) is the most common bacterial disease in childhood worldwide and may have significant adverse consequences, particularly for young children. In this guideline, we provide the most up-to-date information for the diagnosis and management of community-acquired UTI in infants and children aged over 90 days up to 14 years. The current recommendations given by the American Academy of Pediatrics Practice guidelines, Canadian Pediatric Society guideline, and other international guidelines are considered as well as regional variations in susceptibility patterns and resources. This guideline covers the diagnosis, therapeutic options, and prophylaxis for the management of community-acquired UTI in children guided by our local antimicrobial resistance pattern of the most frequent urinary pathogens. Neonates, infants younger than three months, immunocompromised patients, children recurrent UTIs, or renal abnormalities should be managed individually because these patients may require more extensive investigation and more aggressive therapy and follow up, so it is considered out of the scope of these guidelines. Establishment of children-specific guidelines for the diagnosis and management of community-acquired UTI can reduce morbidity and mortality. We present a clinical statement from the Saudi Pediatric Infectious Diseases Society (SPIDS), which concerns the diagnosis and management of community-acquired UTI in children.

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First urinary tract infections in children: the role of the risk factors proposed by the Italian recommendations

Abstract: Among the risk factors proposed by the Italian guidelines, only the presence of a pathogen other than E. coli significantly predicted reflux. Cystography can be postponed in children with no risk factors.

Cited by 26 publications

References 21 publications

Highlights in this issue

Highlights in this issue

Predicting factors of clinically significant urological anomalies after initial urinary tract infection among 2‐ to 24‐month‐old children

Diagnosis and management of community-acquired urinary tract infection in infants and children

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