Urinary Infection Recurrence and Its Related Factors in Urinary Tract Infection

Abstract

Background: Recurrent urinary tract infection (UTI) is one of the major health problems in children because of its high rate of occurrence. This study aimed at evaluating the frequency of recurrent urinary tract infection and related factors in children aged two months to 15 years old, refereed to the pediatric nephrology clinic of Zahedan city. Methods: In this descriptive study, 270 children with urinary tract infection were studied. The sampling method was convenient. Information was gathered from patients and their files. Data was analyzed by the SPSS version 18 software, using Chi Square and T-test. Results: The mean age of the children was 4.3 ± 3.7 years old. Thirty-four children (12.6%) were male and 236 (87.4%) female (P > 0.05). Overall, 109 children (73.6%) with recurrent UTI and 53 children (44.2%) without recurrent UTI had abnormal ultrasonography (P = 0.001). Furthermore, 115 children (76.7%) with recurrent UTI and 100 children (83.3%) with first UTI had positive results for E. coli culture (P = 0.177). Seventy-nine children (54.5%) with recurrent UTI and 61 children (39%) with first UTI were diagnosed to have elimination syndrome (P = 0.067). Abnormal VCUG was found in 39 children (47.6%) of 82 children with recurrent UTI yet children with first UTI had normal VCUG (P = 0.001). Conclusions: There was no difference regarding age, gender, dysfunctional elimination syndrome, and urine culture in children with recurrent UTI compared to those with first UTI, yet abnormal VCUG, kidney, and urinary tract ultrasonography were much more common in children with recurrent UTI.

Urinary Tract Infection: A Common Problem in Pediatrics

“…Other gramnegative microorganisms that cause UTIs include Klebsiella, Proteus mirabilis, Enterobacter, Citrobacter, and Pseudomonas spp. Additionally, gram-positive pathogens can also infect the urinary tract, such as Enterococcus faecalis, Staphylococcus saprophyticus, and group B Streptococcus [5]. Likewise, viruses such as adenoviruses, enteroviruses, coxsackieviruses, and echoviruses can cause UTIs, but they are usually limited to the lower urinary tract.…”

“…We speak of relapse with two or more UTI episodes in a sixmonth period, this usually occurs two weeks after the end of treatment; on the other hand, relapse is called as the repetition of the infection with the pathogen of the previous infection; it should be added that recurrence occurs when there are two types of relapse and reinfection. However, reinfection is considered when the infection reoccurs with a pathogen other than the previous infection episode, this occurs months after the first infection episode [5]. It is estimated that up to 30% of infants and children will experience recurrent infections during the first 6 to 12 months after the initial UTI, being especially more common in girls [1].…”

“…For the investigation of UTI, it is important to carry out a systematic approach mainly in newborns and children younger than 2 years with fever, since this age group generally lacks typical clinical signs (frequency, dysuria, and fever) [6]. Its early and timely diagnosis is essential to start treatment, limit morbidity and kidney damage, since among the early complications of UTI are septicemia or bacteremia and in the late ones, hypertension, chronic renal failure and nephropathy due to reflux [1,5]. Clinically, a newborn may present signs of sepsis, such as temperature instability, peripheral circulatory failure, seizures, apnea, or metabolic acidosis, but we must bear in mind that UTI in newborns and Infants can be related to poor diet, growth retardation, lethargy or irritability, it can even present without fever.…”

“…The main goal of treatment is to prevent repetitive infections and their complications. This requires taking into account different factors such as age, sex, and underlying diseases [5]. In addition, meticulous genital hygiene and adequate fluid intake should be encouraged.…”

Recurrent Cystitis in Children: Preventive Interventions

“…Протягом року після перенесеної інфекції сечових шляхів (ІСШ) повторне інфікування виникає в 25% випадків. Вірогідність загострення у хворих з двома попередніми епізодами досягає 50%, у дітей з трьома попередніми епізодами ІСШ -80% [1]. Найчастіше повторні епізоди інфекції виникають у перші 2-6 міс після перенесеного захворюван-ня [2].…”