Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study

Chong, Siew Lew; Leow, Esther Huimin; Yap, Celeste Jia Ying; Chao, Sing Ming; Ganesan, Indra; Ng, Yong Hong

doi:10.1136/bmjpo-2022-001687

Cited by 4 publications

(5 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, the incidence of UTIs was the highest in the 61-90 days age group. A previous single-center retrospective study investigating UTIs in infants ≤3 months old demonstrated a median age of 63 days [16] and consistent trends in epidemiology.…”

Section: Discussionsupporting

confidence: 59%

The Incidence of Serious/Invasive Bacterial Diseases in Infants 90 Days Old or Younger at an Emergency Hospital in Japan

Yoshitake¹,

Kusama²,

Ito³

et al. 2023

Cureus

View full text Add to dashboard Cite

BackgroundThe incidence of severe bacterial infections (SBIs) in infants aged ≤90 days is thought to have decreased because of widespread vaccination programs. However, relevant epidemiological data in Japan are scarce. Materials and methodsThis observational, single-center study investigated the epidemiology of fever in infants aged ≤90 days. SBI was defined as the presence of meningitis, urinary tract infections (UTIs), or bacteremia. Invasive bacterial infection (IBI) was defined as the presence of meningitis, bacteremic UTI, or bacteremia. We determined the incidence of UTIs, bacteremia, meningitis, SBIs, and IBIs in the following three age groups: 0-28, 29-60, and 61-90 days. We subsequently calculated the relative incidence for the groups aged 29-60 and 61-90 days, using the group aged 0-28 days as the reference group. ResultsHerein, 58, 124, and 166 infants were included in the 0-28 days, 29-60 days, and 61-90 days age groups, respectively. Of the total number of patients, 15.5%, 8.9%, and 16.9% in the 0-28 days, 29-60 days, and 61-90 days age groups, respectively, were diagnosed with SBI. The relative incidences were 1 for the 0-28 days group (reference group), 0.67 for the 29-60 days group (95% confidence interval [CI], 0.39-1.15), and 1.08 for the 61-90 days group (95% CI, 0.58-2.00). Of the total number of patients, 10.3%, 3.2%, and 0.6% in the 0-28 days, 29-60 days, and 61-90 days age groups, respectively, were diagnosed with IBI. Relative incidences were 1 (reference group), 0.50 (95% CI, 0.29-0.88), and 0.28 (95% CI, 0.19-0.41) for the 0-28 days, 29-60 days, and 61-90 days age groups, respectively. All cases of IBI were caused by Group B streptococcus (GBS), except for two cases of bacteremia, which were caused by Haemophilus influenzae. ConclusionThe incidence of SBI was similar in the 0-28 days and 61-90 days age groups. However, the incidence of IBI decreased with increasing age. The incidence of UTIs was highest in the 61-90 days age group, and that of meningitis and bacteremia decreased with increasing age.

show abstract

Section: Discussionsupporting

confidence: 59%

The Incidence of Serious/Invasive Bacterial Diseases in Infants 90 Days Old or Younger at an Emergency Hospital in Japan

Yoshitake¹,

Kusama²,

Ito³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Another parameter strongly related to malformations is infection with a non‐ E. coli pathogen 10,11,21 . In our study, having an infection with an atypical pathogen increased the probability of underlying malformations by four times.…”

Section: Discussionmentioning

confidence: 48%

“…19 Different studies have identified various risk factors associated with NUM, and some heterogeneous recommendations have been made based on these criteria. 10,11,20,21 However, until now, there has yet to be a predictive model with good predictive capacity, based solely on clinical and analytical parameters, capable of stratifying patients into risk groups for individualised imaging protocols.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, UTI recurrence is the primary risk factor, consistent with previous research. 10,20 Having had at least one previous UTI increased the likelihood of having a NUM by nearly 10 times.…”

Section: Discussionmentioning

confidence: 99%

“…9 Amidst this controversy, various urinary tract malformation markers have been proposed to assist clinicians in identifying patients who may require additional diagnostic testing. [10][11][12] This introduction sets the stage for our study, which explores a clinicalanalytical model designed to address these challenges, focusing on predictive variables to optimise the diagnostic process through imaging tests.…”

Section: Backg Rou N Dmentioning

confidence: 99%

See 2 more Smart Citations

NUM‐score: A clinical‐analytical model for personalised imaging after urinary tract infections

González‐Bertolín,

Barbas Bernardos,

Zarauza Santoveña

et al. 2024

Acta Paediatrica

View full text Add to dashboard Cite

AimTo identify predictive variables and construct a predictive model along with a decision algorithm to identify nephrourological malformations (NUM) in children with febrile urinary tract infections (fUTI), enhancing the efficiency of imaging diagnostics.MethodsWe performed a retrospective study of patients aged <16 years with fUTI at the Emergency Department with subsequent microbiological confirmation between 2014 and 2020. The follow‐up period was at least 2 years. Patients were categorised into two groups: ‘NUM’ with previously known nephrourological anomalies or those diagnosed during the follow‐up and ‘Non‐NUM’ group.ResultsOut of 836 eligible patients, 26.8% had underlying NUMs. The study identified six key risk factors: recurrent UTIs, non‐Escherichia coli infection, moderate acute kidney injury, procalcitonin levels >2 μg/L, age <3 months at the first UTI and fUTIs beyond 24 months. These risk factors were used to develop a predictive model with an 80.7% accuracy rate and elaborate a NUM‐score classifying patients into low, moderate and high‐risk groups, with a 10%, 35% and 93% prevalence of NUM. We propose an algorithm for approaching imaging tests following a fUTI.ConclusionOur predictive score may help physicians decide about imaging tests. However, prospective validation of the model will be necessary before its application in daily clinical practice.

show abstract

Risk factors for recurrent urinary tract infections in young infants under the age of 24 months

Son,

Yim

2024

Child Kidney Dis

View full text Add to dashboard Cite

Purpose: Recurrent urinary tract infections (UTIs) in children is a major challenge for pediatricians. This study was designed to investigate the risk factors for recurrent UTIs and determine the association between recurrent UTIs and clinical findings, including growth patterns in infants and children younger than 24 months of age. Methods: We retrospectively reviewed the medical records of 147 patients <24 months of age with UTIs who were hospitalized between August 2018 and October 2021. The patients were divided into recurrent and single UTI episode groups. Clinical findings and anthropometric and laboratory data were compared between the two groups.Results:In the recurrent UTI group, the weight-for-length (WFL) percentile at the first UTI diagnosis was lower compared to the single UTI episode group, and the weight-for-age percentile at 3-month and 6-month follow-ups after the first UTI decreased (all P<0.05). In univariable logistic regression analysis, higher birth weight, lower WFL percentile, the presence of hydronephrosis, acute pyelonephritis or vesicoureteral reflux, the use of prophylactic antibiotics, and non-Escherichia coli infections were associated with the development of recurrent UTIs (all P<0.05). However, in the multivariable analysis, only the presence of hydronephrosis and prophylactic antibiotic use were independently related to UTI recurrence (P<0.05). Conclusion: The presence of hydronephrosis at the first UTI can be helpful for predicting UTI recurrence in young children aged < 24 months. Antibiotic prophylaxis may be associated with UTI recurrence. Potential growth delay should be carefully monitored in infants with recurrent UTI.

show abstract

Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study

Cited by 4 publications

References 33 publications

The Incidence of Serious/Invasive Bacterial Diseases in Infants 90 Days Old or Younger at an Emergency Hospital in Japan

The Incidence of Serious/Invasive Bacterial Diseases in Infants 90 Days Old or Younger at an Emergency Hospital in Japan

NUM‐score: A clinical‐analytical model for personalised imaging after urinary tract infections

Risk factors for recurrent urinary tract infections in young infants under the age of 24 months

Contact Info

Product

Resources

About