Pathogen distribution and risk factors for urinary tract infection in infants and young children with retained double-J catheters

Abstract

Objectives To investigate the pathogens and potential risk factors for urinary tract infection (UTI) in patients with retained double-J catheters (DJCs). Methods In total, 107 infants and young children with DJCs were included in this retrospective analysis. Patients were included in the infection group (n = 30) or non-infection group (n = 77), according to UTI presence or absence. The species and characteristics of pathogens were investigated, and the clinical features of the patients were recorded for further analysis. Results Gram-negative bacilli were the most common causative pathogens (69.2%), among which Escherichia coli was most frequent (38.5%). The second most common causative pathogens were Gram-positive cocci (28.2%), among which Enterococcus faecalis was most frequent (10.3%). UTIs among patients in this study were associated with the following factors: catheter retention (long-term) (odds ratio [OR] = 2.514, 95% confidence interval [CI] = 1.176–5.373), sex (male) (OR = 2.966, 95% CI = 1.032–8.529), DJC retention (long-term) (OR = 1.869, 95% CI = 1.194–2.926), and DJC number (unilateral) (OR = 0.309, 95% CI = 0.103–0.922). Conclusions Infants and young children with DJCs were likely to experience UTIs, mainly caused by Gram-negative bacilli. Long-term catheter retention or DJC retention, male sex, and bilateral DJC retention were risk factors for UTI.

Risk Factors of Urinary Tract Infection in Pediatric Patients with Ureteropelvic Junction Obstruction after Primary Unilateral Pyeloplasty

“…Consistent with our study, gender difference was also observed in patients with UTI after retrograde upper urinary lithotripsy [19]. More similarly, Wang et al found that infants and young children with double-J catheter retention exhibited a higher risk of UTI, largely due to Gram-negative bacilli, and male sex was also a risk factor of UTI [20]. In addition to gender difference, younger age was also considered as a risk factor of UTI, consistent with the previous finding [21].…”

Prediction Model for Urinary Tract Infection in Pediatric Urological Surgery Patients

“…We found that the use of an indwelling drainage tube was a protective factor for UTI, which was inconsistent with prior studies ( 9 , 17 , 18 ). Wang et al performed a retrospective study of 107 infants and young children and found that indwelling drainage tube, male, and double-J catheter retention were independent risk factors for UTI ( 9 ).…”

“…We found that the use of an indwelling drainage tube was a protective factor for UTI, which was inconsistent with prior studies ( 9 , 17 , 18 ). Wang et al performed a retrospective study of 107 infants and young children and found that indwelling drainage tube, male, and double-J catheter retention were independent risk factors for UTI ( 9 ). A retrospective study conducted by Kitano et al showed that the indwelling drainage tube, hydronephrosis, and renal stones were associated with an increased risk for UTI ( 17 ).…”

“…Numerous studies have identified risk factors for UTI in children, including male sex, recurrence of UTI within 3 months, prenatal antibiotic exposure of mothers and infection with Klebsiella species, long-term catheter retention or double-J catheter retention, and bilateral double-J catheter retention (7)(8)(9). The Advanced Analytics Group of Pediatric Urology and ORC Personalized Medicine Group developed a model to predict the probability of recurring UTI associated with vesicoureteral reflux in children after an initial UTI; the model included age, sex, race, weight, systolic blood pressure percentile, dysuria, urine albumin-to-creatinine ratio, previous antibiotic exposure, and current medication (10).…”