Risk Factors of Urinary Tract Infection in Children with Anorectal Malformations

Abstract

Objective: The purpose of this study was to predict risk factors for urinary tract infection (UTI) in children with anorectal malformations (ARMs). Methods:We retrospectively reviewed infants with ARMs who received the three-stage operation at our center from 2019 to January, 2022. Logistic regression analysis was used to assess the association of clinical factors with UTI. Results: 151 children were included with an average age of 8.75 months. 106(70.2%) were male. 71(47.0%) were diagnosed with urinary tract infection before anorectalplasty. 69(45.7%) patients had concomitant genitourinary tract anomalies. 59(39.1%) patients were diagnosed with spinal cord anomalies. Multivariate logistic regression analysis found that gender was the only independent factor associated with the occurrence of UTI (males vs female, OR=7.306, p=0.001, 95%CI=2.315-23.055). 19(12.6%) were diagnosed of recurrent urinary tract infections (RUTI) during follow-up. On multivariate logistic regression, VUR (OR=13.236, p=0.004, 95%CI=2.232-78.500), tethered cord (OR=6.720, p=0.015, 95%CI=1.455-31.026) and fatty filum terminale (OR=6.281, p<0.001, 95%CI=2.263-17.430) were risk factors for RUTI. Conclusions:In ARMs patients, male is the only risk factor to the occurrence of UTI in children before anorectoplasty. And children with VUR, tethered cord and fatty filum terminal are more likely to have recurrent urinary tract infections.