Urinary tract infection in children: Diagnosis, treatment, imaging – Comparison of current guidelines

Okarska‐Napierała, Magdalena; Wasilewska, Anna; Kuchar, Ernest

doi:10.1016/j.jpurol.2017.07.018

Cited by 120 publications

(119 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[20] In the current study, the patients who had been referred after an acute pyelonephritis episode was already treated by primary physicians or pediatricians, and overall imaging tests (US, VCUG, and DMSA scintigraphy) were used in all patients at presentation. A single DMSA scintigraphy was performed ≥1 month after the last documented fUTI to exclude reflux early and avoid additional UTI episodes before delayed DMSA was obtained.…”

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of primary vesicoureteral reflux in children with recurrent urinary tract infections: Diagnostic approach and renal outcomes

Doğan

Koyun

Aksoy

et al. 2018

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: In this study, we aimed to assess renal outcomes of delayed diagnosis of dilating primary vesicoureteral reflux (VUR) following recurrent febrile urinary tract infections (fUTIs) and its diagnostic imaging procedures. Material and methods:The medical records of patients who underwent ultrasonography (US), non-acute dimercaptosuccinic acid (Tc-99mDMSA) scintigraphy and voiding cystourethrography (VCUG), and who were older than 2 years at the time of VUR diagnosis were retrospectively reviewed.Results: A total of 32 children (female, n=27: 84.4%) with a mean age of 7.67±3.34 years at the time of diagnosis of VUR were included in the study. Grade III, IV, V VUR were found in 22%, 69%, and 9% of the patients, respectively. At the time of VUR diagnosis, abnormal US findings were detected in 75% of the cases. Tc-99mDMSA detected abnormalities in 83.9% (7 with a single scar, 7 with multiple lesions, 12 with reduced kidney function) of the patients. Estimated glomerular filtration rate of 3 patients with bilateral grade IV VUR was <75 mL/min/1.73 m 2 . In 5 patients (16%), VUR could not be predicted by US+DMSA scintigraphy (Grade IV VUR in 3 and Grade III in 2 cases ). The sensitivity in predicting VUR was 75.00% , respectively, for US alone and combined US+DMSA. Conclusion:VCUG should be performed routinely in addition to US and non-acute DMSA in all children referred with recurrent fUTIs. Awareness of childhood UTI in public and healthcare personnels should be increased in order to refer these patients at a early stage to pediatric urology and nephrology units.

show abstract

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of primary vesicoureteral reflux in children with recurrent urinary tract infections: Diagnostic approach and renal outcomes

Doğan

Koyun

Aksoy

et al. 2018

Turkish Journal of Urology

View full text Add to dashboard Cite

show abstract

“…Because of the risk of renal scarring, VCUG or DMSA scanning is recommended after febrile UTI. Recently, indications for both are becoming more restricted due to significant radiation exposure, risk of catheter‐induced UTI, distress for children and their parents, and cost …”

Section: Moves To Reduce Vcugmentioning

confidence: 99%

Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children

et al. 2018

View full text Add to dashboard Cite

Voiding cystourethrography is the most important fluoroscopic examination in pediatric urology for the investigation of lower urogenital tract diseases, such as vesicoureteral reflux or urethral stricture. However, this invasive procedure imposes a significant burden on children and their parents, and recently there has been a paradigm shift in the diagnosis and treatment of vesicoureteral reflux. In the 2011 revision, the American Academy of Pediatrics guidelines on urinary tract infection recommended abandoning routine voiding cystourethrography after the first febrile urinary tract infection. In 2014, the randomized intervention for children with vesicoureteral reflux study recommended discontinuation of routine continuous antibiotic prophylaxis for vesicoureteral reflux. The time is now ripe to radically reconsider indications for voiding cystourethrography and the procedure itself.

show abstract

“…Sometimes UTI, however, cannot be identified in a timely manner in children because of their non‐specific signs and symptoms. It is very difficult to elucidate symptoms of UTI especially in children aged <2–3 years . Besides clinical manifestation, UTI diagnosis requires the confirmation of pyuria on urinalysis and ≥50 000 colonies/mL of pathogen in midstream urine culture…”

mentioning

confidence: 99%

“…It is very difficult to elucidate symptoms of UTI especially in children aged <2-3 years. 3,4 Besides clinical manifestation, UTI diagnosis requires the confirmation of pyuria on urinalysis and ≥50 000 colonies/mL of pathogen in midstream urine culture. 5 Once an infection is detected, empirical antibiotics will be given first, and then adjusted accordingly based on urine culture and sensitivity test.…”

mentioning

confidence: 99%

Risk factors affecting the prognosis of urinary tract infection in Chinese pediatric patients: Single‐center experience

Wang

Zhu

Huang

et al. 2020

Pediatrics International

View full text Add to dashboard Cite

Background Urinary tract infection (UTI) is common in children. The purpose of this retrospective study was to determine the various risk factors that usually affect the prognosis of UTI in children diagnosed with the disease. Methods In the present retrospective study, we enrolled all pediatric patients diagnosed with UTI and hospitalized between 1 January 2013 and 31 July 2016 at Nanjing Children's Hospital. We then collected all the relevant patient clinical demographics and characteristics. Results The study involved 2,092 pediatric patients diagnosed with UTI. On logistic regression analysis, factors that could affect the prognosis of pediatric UTI were complications, hospitalization, intensive care unit (ICU) admission, type of UTI, urine culture results, blood lymphocytes, urine nitrites (NIT) and antibiotics (unstandardized coefficients, 0.06, <0.001, −0.28, 0.32, <0.001, 0.01, −0.11, 0.01, respectively, all P < 0.001). Conclusion Complications, hospitalization, type of UTI, urine culture results, blood lymphocytes, and antibiotics had a significant, positive association with UTI prognosis. Meanwhile, ICU admission and urine NIT had a negative association with prognosis.

show abstract

Urinary tract infection in children: Diagnosis, treatment, imaging – Comparison of current guidelines

Cited by 120 publications

References 36 publications

Delayed diagnosis of primary vesicoureteral reflux in children with recurrent urinary tract infections: Diagnostic approach and renal outcomes

Delayed diagnosis of primary vesicoureteral reflux in children with recurrent urinary tract infections: Diagnostic approach and renal outcomes

Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children

Risk factors affecting the prognosis of urinary tract infection in Chinese pediatric patients: Single‐center experience

Contact Info

Product

Resources

About