Adherence to AAP Practice Guidelines for Urinary Tract Infections at Our Teaching Institution

Shah, Lopa; Mandlik, Nandini; Kumar, Payal; Andaya, Serjun; Patamasucon, Pisespong

doi:10.1177/0009922808319962

Cited by 15 publications

(10 citation statements)

References 3 publications

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“…In girls, the moist periurethral and vaginal areas promote the growth of uropathogens. The shorter urethral length increases the chance for ascending infection into the urinary tract, which is consistent with Shah et al 18 .…”

Section: Discussionsupporting

confidence: 90%

Detection of ESBL Producing Bacteria in Cases of Urinary Tract Infection in Pediatric Department at Benha University Hospital

Ramadan

Bassyoni

Amer

et al. 2016

EJMM

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Background: Extended-spectrum beta-lactamases (ESBLs) are rapidly evolving group of beta-lactamase enzymes commonly produced by the Gram negative bacteria. Objectives: This work aimed to detect the bacterial pathogens that cause urinary tract infection and to detect ESBL producing bacteria among them in Pediatric Department at Benha University Hospital. Methodology: This study was conducted on 118 children patients suffering from UTI collected from Outpatient and Inpatient of pediatric department at Benha University during the period from January 2015 to the end of July 2015. They were 77 girls and 41 boys and their ages ranged from 1 to 13 years.118 Urine samples were subjected to isolation and identification of causative organisms, screened for ESBL production by the pattern of antimicrobial susceptibilities. Phenotypic identification for ESBL production was confirmed by double disc diffusion test, bla SHV and bla CTX-M genes in ESBL, producing isolates were detected by using multiplex PCR. Results: This study showed that the most common cause of children UTI was E.coli (55.1%) followed by klebsiella pneumoniae (21.2%). Thirty seven (31.4%) of 118 bacterial isolates that tested by double disc confirmatory test were ESBL positive. Among the ESBL producing bacteria, 16 out of 37 (43.24%) have CTX-m and SHV genes together while 3 out of 37 (8.1%) have SHV gene only. Conclusion: Our findings showed that majority of ESBL isolates were positive for both CTXm and SHV genes (43.24%) but SHV gene alone was positive only in (8.1%) of isolates, So studies should be done in different regions of Egypt to find the common ESBL genes present in that geographical area for epidemiological purposes. Also ESBL producing isolates have been increasingly recognized in hospitals in Egypt and are associated with multiple drug resistance. Thus, ESBL producing organisms should be identified quickly so that appropriate antibiotic usage and infection control measures can be implemented.

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Section: Discussionsupporting

confidence: 90%

Detection of ESBL Producing Bacteria in Cases of Urinary Tract Infection in Pediatric Department at Benha University Hospital

Ramadan

Bassyoni

Amer

et al. 2016

EJMM

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“…Low compliance with imaging recommendations of the recently replaced AAP practice guideline has previously been reported – as low as 61% in an academic setting 12 and 28% in a Medicaid population. 13 With VCUG no longer part of the initial workup for febrile UTI, we hope that children will not be allowed to undergo multiple episodes of pyelonephritis before undergoing imaging for VUR.…”

Section: Discussionmentioning

confidence: 97%

Incidence of Abnormal Imaging and Recurrent Pyelonephritis after First Febrile Urinary Tract Infection in Children 2 to 24 Months Old

et al. 2013

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Purpose The American Academy of Pediatrics no longer recommends a voiding cystourethrogram (VCUG) for children aged 2 to 24 months presenting with their first urinary tract infection (UTI) if renal-bladder ultrasound (RBUS) is normal. Our goal was to identify factors associated with abnormal imaging and recurrent pyelonephritis for this population. Materials and Methods We retrospectively evaluated children diagnosed with first episode of pyelonephritis between 2 to 24 months using de-identified electronic medical record data from an institutional database. Data included age at first UTI, gender, race/ethnicity, need for hospitalization, intravenous antibiotic use, history of abnormal prenatal ultrasound, RBUS and VCUG results, UTI recurrence and surgical intervention. Risk factors for abnormal imaging and UTI recurrence were analyzed with univariate logistic regression, chi square and survival analysis. Results We identified 174 patients. Of 154 RBUS performed, 59 (38%) were abnormal. Abnormal prenatal ultrasound (p=0.01) and need for hospitalization (p=0.02) predicted abnormal RBUS. Of the 95 patients with normal RBUS, 84 had a VCUG. Vesicoureteral reflux was more likely in Caucasians (p=0.003), females (p=0.02) and older patients (p=0.04). Despite normal RBUS, 23 of 84 (24%) patients had dilating vesicoureteral reflux. Of the 95 patients with normal RBUS, 14 (15%) had recurrent pyelonephritis and 7 (7%) went on to surgical intervention. Conclusions Despite a normal RBUS after first episode of pyelonephritis, a child may still have vesicoureteral reflux, recurrent pyelonephritis, and need for surgical intervention. If VCUG is deferred, parents should be counseled regarding these risks.

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“…Because of the potential severity of such infections, the workup is an important part of management. Protocols for evaluation of any urinary tract abnormalities, appropriate management is essential [14].…”

Section: Discussionmentioning

confidence: 99%

Screening for Urine Abnormalities Among School Children in Qalubyia

Shalaby¹,

Hameed

Affifi

et al. 2019

GEGET

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Background Early identification of kidney diseases in children and adolescents is an important initial step in prevention of chronic kidney diseases (CKD). The current study was undertaken to screen asymptomatic school children in Qalubyia governate, Egypt, and to detect the prevalence of renal disorders using urine dipstick method. Aim of Work The purpose of the study was to determine the prevalence of urinary abnormalities by dipstick test (reagent strips) in asymptomatic school children. Patients and Method This cross sectional study, was carried out in Qalubyia Governorate, from September 2018 to February 2019. It comprised (1000) school children of both sexes after obtaining an informed consent from the children's care givers. Ages of the children included in the study ranged from 6 to 12 years and they were 411 males (41.1%) and 589 females (58.9%). Results Out of total 1000 children, 411 (41.1%) were male children and remaining 589 (58.9%) were female students. During the first screening by urine dipstick method, 66 (6.6%) children were found to having urinary abnormalities which were further investigated by confirmatory complete urine analysis. Finally 33 were diagnosed having urinary abnormalities. The prevalence rate of isolated hematuria (IH) was 0.9%; isolated proteinuria (IP) was 0.4%; combined hematuria and proteinuria (CHP) was 0.1% and urinary tract infection (UTI) was 1.8% and Glycosuria was 0.1%. In microscopic urine examination, crystals was found positive in 0.8% of the cases. Abnormality in sonography of kidneys were found in 5 cases. Urine culture results were positive in 8 cases. Conclusions In conclusion, asymptomatic urinary abnormalities might be detected by urine screening program at school age.

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Adherence to AAP Practice Guidelines for Urinary Tract Infections at Our Teaching Institution

Cited by 15 publications

References 3 publications

Detection of ESBL Producing Bacteria in Cases of Urinary Tract Infection in Pediatric Department at Benha University Hospital

Detection of ESBL Producing Bacteria in Cases of Urinary Tract Infection in Pediatric Department at Benha University Hospital

Incidence of Abnormal Imaging and Recurrent Pyelonephritis after First Febrile Urinary Tract Infection in Children 2 to 24 Months Old

Screening for Urine Abnormalities Among School Children in Qalubyia

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