Urinary tract infections in children below two years of age: a quality assurance project in Sweden

Abstract

The objective of this study was to evaluate the basis for diagnosis and assessment of children <2 y of age with urinary tract infections (UTI) and to describe their subsequent management as currently practised in Sweden. The study was a prospective, multicentre project as part of a programme for quality assurance. A total of 2309 children (1111M, 1198F) was studied during a 2-y period. Of the population at risk, 1.6% of both boys and girls were diagnosed with a UTI. This represents a minimum figure. Suprapubic bladder aspiration was mainly used during the first year of life, with the highest frequency in the youngest infants. Adhesive bags were used in half of the children, and the frequency increased with age. Imaging of the urinary tract was performed in 97% of the children. Vesicoureteric reflux was the most common finding, occurring in 36% of the girls and 24% of the boys. The presence of dilatation of the upper urinary tract correlated significantly to the presence and grade of reflux. Initial intravenous therapy was given to 31% of the children and long-term antibacterial prophylaxis to 20%. Major differences were found between centres in diagnostic rate, urine sampling technique and the use of parenteral therapy. In conclusion, this study showed a high diagnostic rate of urinary infections in children below 2 y of age. The urine sampling technique was optimal (suprapubic aspiration) in half of the infants, but less reliable in the children above 1 y of age. The frequency of imaging investigations of the urinary tract was high. The strategies for diagnosis and treatment varied considerably among centres.

Bedside diagnosis of outpatient childhood urinary tract infection using three-media dipslide culture test

“…They have a reported incidence of 6.6% and are commonly seen among children under 7 years old, with a peak occurrence in infants from 0-12 months [1,2]. They usually carry a very good prognosis; however, undiagnosed UTI will often lead to acute morbidity and may result in long-term medical complications, including hypertension and reduced renal function, specifically among children with congenital renal scars.…”

The Efficacy and Safety of Ertapenem Therapy in Children with Urinary Tract Infections due to ESBL-Producing Microorganisms

“…[18] In studies, vesicoureteral reflux has been the most frequently seen urinary system anomaly, and the most frequently encountered predisposing factor for UTI. [19,20] In the present study, among diseases predisposing to UTI, we most frequently detected neurogenic bladder secondary to spina bifida.…”

Infecção do trato urinário: em busca das evidências

“…Hansson et al 21 desenvolveram na Suécia um projeto multicêntrico, prospectivo, de dois anos de duração, para avaliação da qualidade do diagnóstico e seguimento da primoinfecção urinária em pacientes abaixo de dois anos de idade. Foram avaliadas 2.309 crianças.…”