Repeat Urine Cultures in Children Who Are Admitted With Urinary Tract Infections

Oreskovic, Nicolas M.; Sembrano, Eduardo U

doi:10.1542/peds.2006-1134

Cited by 22 publications

(15 citation statements)

References 14 publications

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“…Revising the antibiotic selection might be needed. Repeat urine cultures after treatment are not needed in children who show clinical response to treatment [47, 48]. Children on prophylactic antibiotics for VUR might present a challenge to treatment as they are more likely to have UTI with a resistant organism [11, 49].…”

Section: Uti Treatmentmentioning

confidence: 99%

Managing urinary tract infections

Saadeh

Mattoo

2011

Pediatr Nephrol

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Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-stage renal failure. The relevance and the sequence of the renal imaging following initial UTI, and the role of antimicrobial prophylaxis and surgical intervention are currently undergoing an intense debate. Prompt treatment of UTI and appropriate follow-up of those at increased risk of recurrence and/or renal scarring are important.

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Section: Uti Treatmentmentioning

confidence: 99%

Managing urinary tract infections

Saadeh

Mattoo

2011

Pediatr Nephrol

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“…Retrospective studies did not show "proof of bacteriologic cure" cultures to be beneficial. 47,48 Studies demonstrating that clinical response alone ensures bacteriologic cure are not available.…”

Section: Proof Of Curementioning

confidence: 99%

Diagnosis and Management of an Initial UTI in Febrile Infants and Young Children

Finnell¹,

Carroll²,

Downs³

2011

Pediatrics

176

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OBJECTIVES: The diagnosis and management of urinary tract infections (UTIs) in young children are clinically challenging. This report was developed to inform the revised, evidence-based, clinical guideline regarding the diagnosis and management of initial UTIs in febrile infants and young children, 2 to 24 months of age, from the American Academy of Pediatrics Subcommittee on Urinary Tract Infection. METHODS: The conceptual model presented in the 1999 technical report was updated after a comprehensive review of published literature. Studies with potentially new information or with evidence that reinforced the 1999 technical report were retained. Meta-analyses on the effectiveness of antimicrobial prophylaxis to prevent recurrent UTI were performed. RESULTS: Review of recent literature revealed new evidence in the following areas. Certain clinical findings and new urinalysis methods can help clinicians identify febrile children at very low risk of UTI. Oral antimicrobial therapy is as effective as parenteral therapy in treating UTI. Data from published, randomized controlled trials do not support antimicrobial prophylaxis to prevent febrile UTI when vesicoureteral reflux is found through voiding cystourethrography. Ultrasonography of the urinary tract after the first UTI has poor sensitivity. Early antimicrobial treatment may decrease the risk of renal damage from UTI. CONCLUSIONS: Recent literature agrees with most of the evidence presented in the 1999 technical report, but meta-analyses of data from recent, randomized controlled trials do not support antimicrobial prophylaxis to prevent febrile UTI. This finding argues against voiding cystourethrography after the first UTI.

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“…There are few studies that have investigated the between-country differences of UTI-causative bacteria, and that have focused on the comparison between developed and developing countries. In addition, for pediatric UTI, the characteristics of antibiotic susceptibilities of causative pathogens in this population have not been well-examined, despite the UTI being one of the leading cause of all pediatric infections in Surabaya (9).…”

Section: Introductionmentioning

confidence: 99%

International Comparison of Causative Bacteria and Antimicrobial Susceptibilities of Urinary Tract Infections between Kobe, Japan, and Surabaya, Indonesia

Kitagawa¹,

Shigemura

Yamamichi

et al. 2018

Jpn J Infect Dis

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SUMMARY:Variation by country in urinary tract infection (UTI)-causative bacteria is partly due to the differences in the use of antibiotics. We compared their frequencies and antibiotic susceptibilities in the treatment of patients with UTI from 2 cities, Kobe, Japan, and Surabaya, Indonesia. We retrospectively analyzed 1,804 urine samples collected from patients with UTI in 2014 (1,251 collected in 11 months at Kobe University Hospital in Kobe and 544 collected in 2 months at Dr. Soetomo Hospital in Surabaya). Surabaya data were divided into adult and pediatric patients because a substantial number of specimens from pediatric-patients had been collected. The results indicated that Escherichia coli was the most common uropathogen (24.1 in Kobe and 39.3 in Surabaya) and was significantly resistant to ampicillin and substantially to first-and third-generation cephalosporins in Surabaya adults but not in Kobe adults (p ＜ 0.01). Enterococcus faecalis was often isolated in Kobe (14.0 ), but not in Surabaya (5.3 ). Klebsiella spp. were isolated at a higher rate in Surabaya pediatric patients (20.3 ) than in Surabaya adults (13.6 ) and Kobe adults (6.6 ). The antibiotic susceptibilities of the isolates form Surabaya isolates tended to be lower than the ones from Kobe. Extended-spectrum β-lactamaseproducing Gram-negative bacteria were detected at a significantly higher rate in Surabaya than in Kobe (p ＜ 0.001). These results showed that the antimicrobial resistance patterns of UTI-causative bacteria are highly variable among 2 countries, and the continuous surveillance of trends in antibiotic resistance patterns of uropathogens is necessary for the future revision of antibiotic use.

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Repeat Urine Cultures in Children Who Are Admitted With Urinary Tract Infections

Abstract: Positive repeat urine cultures after 2 days of antibiotics are exceedingly rare. Elimination of mandatory "proof-of-bacteriologic-cure" benchmarks before hospital discharge is supported by this study.

Cited by 22 publications

References 14 publications

Managing urinary tract infections

Managing urinary tract infections

Diagnosis and Management of an Initial UTI in Febrile Infants and Young Children

International Comparison of Causative Bacteria and Antimicrobial Susceptibilities of Urinary Tract Infections between Kobe, Japan, and Surabaya, Indonesia

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