Association of Pyuria with Uropathogens in Young Children

Nadeem, Shahid; Manuel, Matthias M.; Oke, Oluwaseun; Patel, Vatsal; Filkins, Laura; Badawy, Mohamed; Park, Jason; Hennes, Halim M.

doi:10.1016/j.jpeds.2022.01.048

Cited by 8 publications

(2 citation statements)

References 18 publications

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“…A recent retrospective study by Nadeem et al on 1916 children less than 24 months of age, where 98.3% of urine specimens were collected by catheterization and only growth of > 50,000 CFU/mL was considered signi cant, showed a very similar bacteriologic spectrum and nitrite positivity while pyuria was more prevalent in our study [27]. Similar to other reports we found non-E. coli in 10% of the infants, with comparable rates of Enterococcus and Klebsiella species [27][28][29]. These results indicate that disregarding urine cultures with low bacterial counts and absent or low-grade pyuria in this age group could lead to a missed or delayed diagnosis and treatment.…”

Section: Discussionsupporting

confidence: 67%

“…Furthermore, urinalysis and bacterial species found in urine cultures were similar to previous studies applying more strict UTI criteria. A recent retrospective study by Nadeem et al on 1916 children less than 24 months of age, where 98.3% of urine specimens were collected by catheterization and only growth of > 50,000 CFU/mL was considered signi cant, showed a very similar bacteriologic spectrum and nitrite positivity while pyuria was more prevalent in our study [27]. Similar to other reports we found non-E. coli in 10% of the infants, with comparable rates of Enterococcus and Klebsiella species [27][28][29].…”

Section: Discussionsupporting

confidence: 67%

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Infant urinary tract infection in Sweden – a national study of current diagnostic procedures, imaging and treatment

Lindén,

Rosenblad,

Rosenborg

et al. 2024

Preprint

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Background: Urinary tract infection (UTI) in infants is a common, potentially life-threatening bacterial infection, and must be managed carefully through the entire chain of care from diagnosis, choice of treatment, follow-up and risk stratification of future complications. This Swedish nationwide study of infant UTI was conducted to evaluate the current management of infant UTI, yield of investigations and the Swedish UTI guidelines’ ability to detect abnormalities of importance in the urinary tract. Methods Infants < 1 year with a first episode of UTI were included in a prospective multicenter study. Treatment and follow-up were provided by local pediatricians. Clinical and laboratory findings and imaging results were reported to the coordinating center. The current management and results were compared with a previous Swedish study. Results 1306 infants were included. Urine sampling was performed with clean catch technique in 93% of patients. Initial oral antibiotic treatment was used in 63%, predominantly third generation cephalosporines. Permanent kidney abnormalities were found in 10% and dilating vesicoureteral reflux (VUR) in 8%, both representing minimum rates as not all infants were investigated. UTI recurrences were reported in 18%. Conclusion Infant UTI is still generating a considerable amount of follow-up examinations. There is a significant shift towards clean catch as the main urine sampling method. Voiding cystourethrography is performed less frequently reducing the findings of low grade VUR. The incidence of renal scarring is comparable with earlier studies which suggests that the Swedish guidelines are able to identify individuals with risk for long term complications.

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Section: Discussionsupporting

confidence: 67%