Urinary tract infections and diurnal incontinence in girls

Sørensen, Kaspar; Lose, Gunnar; Nathan, E.

doi:10.1007/bf00445924

Cited by 27 publications

(17 citation statements)

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“…The study used urine bag samples in children younger than 2years of age. Studies have shown culture of such urine specimens has an unacceptably high false positive rate and are valid only when they yield negative results [37, 38]. Kebira et al in 2009 using the criteria of significant bacteriuria and pyuria to define UTI found a higher prevalence of 16% in children aged 1-4years attending both outpatient and inpatient services at Thika Sub-county Hospital, Kenya [39], although they also used urine bags for children less than 3 years.…”

Section: Discussionmentioning

confidence: 99%

Contribution of urinary tract infection to the burden of febrile illnesses in young children in rural Kenya

et al. 2017

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IntroductionThe clinical features of UTI in young children may not localize to the urinary tract and closely resemble other febrile illnesses. In malaria endemic areas, a child presenting with fever is often treated presumptively for malaria without investigation for UTI. Delayed or inadequate treatment of UTI increases the risk of bacteremia and renal scarring in young children and subsequently complications as hypertension and end stage renal disease in adulthood.MethodsA cross-sectional study was carried out in a hospital in western Kenya. Inpatients and outpatients 2 months to five years with axillary temperature ≥37.5°C and no antibiotic use in the previous week were enrolled between September 2012 and April 2013. Urine dipstick tests, microscopy, and cultures were done and susceptibility patterns to commonly prescribed antibiotics established. UTI was defined as presence of pyuria (a positive urine dipstick or microscopy test) plus a positive urine culture.ResultsA total of 260 subjects were recruited; 45.8% were female and the median age was 25months (IQR: 13, 43.5). The overall prevalence of UTI was 11.9%. Inpatients had a higher prevalence compared to outpatients (17.9% v 7.8%, p = 0.027). UTI co-existed with malaria but the association was not significant (OR 0.80, p = 0.570). The most common organisms isolated were Escherichia coli (64.5%) and Staphylococcus aureus (12.9%) and were sensitive to ciproflaxin, cefuroxime, ceftriaxone, gentamycin and nitrofurantoin but largely resistant to more commonly used antibiotics such as ampicillin (0%), amoxicillin (16.7%), cotrimoxazole (16.7%) and amoxicillin-clavulinate (25%).ConclusionOur study demonstrates UTI contributes significantly to the burden of febrile illness in young children and often co-exists with other infections. Multi-drug resistant organisms are common therefore choice of antimicrobial therapy should be based on local sensitivity pattern.

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Section: Discussionmentioning

confidence: 99%

Contribution of urinary tract infection to the burden of febrile illnesses in young children in rural Kenya

et al. 2017

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“…6,[14][15][16] With a prevalence of UTI of 5% and a high rate of false-positive results (specificity: ϳ63%), a "positive" culture result for urine collected in a bag would be a false-positive result 88% of the time. For febrile boys, with a prevalence of UTI of 2%, the rate of false-positive results is 95%; for circumcised boys, with a prevalence of UTI of 0.2%, the rate of false-positive results is 99%.…”

Section: Diagnosis Action Statementmentioning

confidence: 99%

Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months

Roberts¹

2011

Pediatrics

1,390

634

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OBJECTIVE: To revise the American Academy of Pediatrics practice parameter regarding the diagnosis and management of initial urinary tract infections (UTIs) in febrile infants and young children. METHODS:Analysis of the medical literature published since the last version of the guideline was supplemented by analysis of data provided by authors of recent publications. The strength of evidence supporting each recommendation and the strength of the recommendation were assessed and graded.

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“…4 Before the amount of residual urine is measured or urodynamic investigations are started, however, the symptoms of the child should be analysed. The most obvious symptom of bladder dysfunction is incontinence, which is associated with urinary infection.5 6 The incidence of other symptoms suggestive of bladder dysfunction is, however, not known. We therefore studied the association between current symptoms suggestive of bladder dysfunction and a history of previous urinary infections in an unselected group of 7 year old school entrants.…”

mentioning

confidence: 99%

Association between urinary symptoms at 7 years old and previous urinary tract infection.

Hellström

Hanson

Hansson

et al. 1991

Archives of Disease in Childhood

314

114

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The association between current micturition habits and previous urinary tract infection was analysed among 3553 school entrants aged 7 years by means of a questionnaire. A high incidence of urinary infection, confirmed by urine culture, was found (145 (8-4%) in the 1719 girls and 32 (1-7%) in the 1834 boys). There was a significant association between current symptoms that were suggestive of disturbed bladder function and previous urinary tract infection, but only among girls who were over 3 years of age at the time the first episode was diagnosed. Another important abnormality in children with recurrent urinary infections is poor coordination between the detrusor and the sphincter.4 Before the amount of residual urine is measured or urodynamic investigations are started, however, the symptoms of the child should be analysed. The most obvious symptom of bladder dysfunction is incontinence, which is associated with urinary infection.5 6 The incidence of other symptoms suggestive of bladder dysfunction is, however, not known. We therefore studied the association between current symptoms suggestive of bladder dysfunction and a history of previous urinary infections in an unselected group of 7 year old school entrants.Subjects and methods All Swedish children attend a health examination together with a parent and the teacher on entering school at the age of 7. Different problems are discussed with the school physician and the school nurse. Before this examination a health questionnaire is given to the families, to use as a basis for discussion. In 1982 an additional questionnaire about current micturition habits and urinary incontinence was given to all Swedish speaking school entrants in Goteborg by the school nurses.7 Previous urinary infections and other diseases of the urinary tract were also investigated. If there was anything abnormal or unanswered in the questionnaire the family was contacted by telephone for more details by one of the investigators. Children with problems were offered further examination at the children's hospital.Nocturnal as well as diurnal incontinence was defined as wetting at least once during a three month period. Urgency was defined as a short latent period between the first sensation and the need to void that occurred daily. Children who were able to postpone micturition voluntarily while they were occupied were not considered to have urgency. A specific question was asked about the use of a squatting position to prevent incontinence (the 'curtsy' sign8) and whether this was used at least once a week. A child was considered to have emptying difficulties when symptoms such as starting difficulties, poor or interrupted stream, straining or manual compression of the bladder, or prolonged micturition occurred more than twice a week.The original records from hospitals and outpatient clinics of children who gave a history of urinary infections or other diseases of the urinary tract were studied, and the diagnosis of urinary tract infection re-evaluated. The growth of at least 105 ...

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Urinary tract infections and diurnal incontinence in girls

Cited by 27 publications

References 3 publications

Contribution of urinary tract infection to the burden of febrile illnesses in young children in rural Kenya

Contribution of urinary tract infection to the burden of febrile illnesses in young children in rural Kenya

Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months

Association between urinary symptoms at 7 years old and previous urinary tract infection.

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