Urinary Tract Infections in Children

Rushton, H. Gil

doi:10.1016/s0031-3955(05)70551-4

Cited by 189 publications

(37 citation statements)

References 133 publications

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“…It was also greater than the incidence of neonatal bacteruria (1.0 to 1.4%) and bacteruria during the first year of life (3.7% in boys and 2.0% in girls), which have been reported both in European and American studies [9,10]. After the isotope-scan survey, it was observed that, in the UTI group (n=16), ten of the 16 (63%) had urinary retention in the collecting system and two of the16 (13%) exhibited normal renal scan and cystogram.…”

Section: Discussionmentioning

confidence: 67%

Neonates with extra-renal pelvis: the first 2 years

et al. 2005

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Extra-renal pelvis (ERpel) is a common ultrasonographic finding among neonates who have undergone recurrent ultrasound examinations for a better definition of prenatal renal pelvic dilatation. This study tries to determine whether or not ERpel has important prognostic implications. Seventy-nine neonates (17 female) were examined. All had a diagnosis of prenatal renal pelvis dilatation, which was shown by postnatal ultrasound to be ERpel. Sixty ERpel neonates were examined 1.5 months to 2.5 months after the ultrasound (US) diagnosis by both Tc-99m diethylene triamine penta-acetic acid (DPTA) dynamic renal scanning and (99m)Tc-pertechnetate direct cystography. Clinical assessment, urine cultures and renal ultrasound follow-up were maintained for 2 years. The proportion of urinary tract infections (UTIs) in patients with ERpel was compared with that of the total neonatal and infantile population with normal US scans in the region of our hospital. Associated minor congenital malformations were found in 12 of 79 neonates (15.2%). Four had a family history of ERpel. Among 60 neonates who underwent renal scanning, 36 (60%) were found to have urinary retention in the collecting system. Another nine (15%) had vesico-ureteral (VU) reflux, of which seven had urinary retention. Fifteen (25%) showed normal isotope imaging. Urinary tract infection was diagnosed in 16 ERpel neonates in whom only one exhibited VU reflux (grade 2). The incidence of neonatal UTI in the ERpel group was more than that of either neonatal or infantile UTI in those with normal US scans in the local population (20.2% vs 1.2% and 4.3%, respectively). Fifty-three infants completed a 2-year follow-up. Repeat renal ultrasonography indicated that one infant (1.8%) had developed bilateral hydronephrosis, 12 (22.6%) had unchanged findings, 18 (40%) showed an improvement (decrease of ERpel width or resolution in one side) and, in 22 (41.5%) infants, the condition had resolved. No clinical or kidney function deterioration was observed. Seven patients (13.2%) each had one episode of UTI during the 2-year follow-up period; none of them had VU reflux. Neonatal ERpel is more frequent in male infants. It is associated with greater rates of minor congenital malformations, VU reflux and UTI than in the general population of the same ages. The increased UTI incidence is not attributed to VU reflux.

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Section: Discussionmentioning

confidence: 67%

Neonates with extra-renal pelvis: the first 2 years

et al. 2005

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“…Other indications for long-term prophylaxis include children with frequent symptomatic recurrences (>three per year), particularly when these are associated with underlying bladder instability or abnormal voiding patterns. Antibacterial prophylaxis is also considered in neonates and infants less than 1 year of age who present with a febrile UTI, because approximately one-third of these children are at risk for symptomatic recurrences, more than 90% of which are clinically consistent with pyelonephritis or even urosepsis [14].…”

Section: Current Clinical Indications For Antibacterial Prophylaxismentioning

confidence: 99%

“…Today, most clinicians believe that in children with UTI and VUR, the refluxing kidney is most at risk of both congenital and acquired renal damage, and that this risk increases with severity of reflux [14,58,59]. The combination of recurrent UTI, severe VUR, and the presence of renal scarring at first presentation are associated with the worst prognosis.…”

Section: How Effective Is Long-term Prophylaxis In Preventing Renal Smentioning

confidence: 99%

May we go on with antibacterial prophylaxis for urinary tract infections?

Beetz¹

2005

Pediatr Nephrol

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Recurrent urinary tract infections (UTIs), with or without vesicoureteric reflux (VUR), are by far the most frequent reason for long-term antibacterial prophylaxis in infants and children today. However, the strategies of antibacterial prophylaxis for the prevention of recurrent urinary tract infection are no longer universally accepted. In infants and children at risk, the benefits of antibacterial prophylaxis definitively are not yet proven by evident data. To put antibacterial prophylaxis in its place, risk groups for recurrent symptomatic infections, ascending UTI and permanent renal damage have to be defined and the efficacy of prophylaxis in these groups has to be proved by prospective randomised studies. Nevertheless, until the results of these studies are available, antibacterial prophylaxis will remain one of the most frequently practised methods to protect risk patients from pyelonephritic damage and UTI recurrences.

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“…Urinary tract infection (UTI) is one of the most common infectious diseases in children [1]. Based on current studies, the prevalence of UTI varies from 1.8 to 7.5% [2].…”

Section: Introductionmentioning

confidence: 99%

The Association between Vitamin D Levels and Urinary Tract Infection in Children

et al. 2015

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Aim: We aimed to examine whether there is any association between serum levels of 25-hydroxyvitamin D [25(OH)D₃] and urinary tract infection (UTI) among children. Methods: White blood cell count, serum C-reactive protein, calcium, phosphorus, alkaline phosphatase, parathormone, and serum 25(OH)D₃ levels were measured in 82 children experiencing a ﬁrst episode of UTI, with no risk factors for UTI, and 64 healthy control children. Results: The mean serum levels of 25(OH)D₃ among children with UTI were significantly lower than those of controls (11.7 ± 3.3 vs. 27.6 ± 4.7 ng/ml; p < 0.001). The serum levels of 25(OH)D₃ were significantly lower in patients with acute pyelonephritis compared to patients with lower UTI (8.6 ± 2.8 vs. 14.2 ± 3.0 ng/ml; p < 0.001). Within the study group, mean serum levels of 25(OH)D₃ among girls were lower than those of boys (10.9 ± 3.4 ng/ml vs. 13.2 ± 4.4 ng/ml; p < 0.001). Multivariate analysis showed that a serum 25(OH)D₃ level of <20 ng/ml (odds ratio 3.503, 95% confidence interval 1.621-7.571; p = 0.001) was associated with UTI in children. Conclusions: Our results suggest that vitamin D deficiency may be a risk factor for UTI in children.

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Urinary Tract Infections in Children

Cited by 189 publications

References 133 publications

Neonates with extra-renal pelvis: the first 2 years

Neonates with extra-renal pelvis: the first 2 years

May we go on with antibacterial prophylaxis for urinary tract infections?

The Association between Vitamin D Levels and Urinary Tract Infection in Children

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