Urinary Tract Infections in Infants and Children

Schlager, Theresa A.

doi:10.1128/microbiolspec.uti-0022-2016

Cited by 39 publications

(55 citation statements)

References 43 publications

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“…In children (1 to 5 years old), the UTI incidence is 0.9–1.4% in girls and 0.1–0.2% in boys, while in children older than 6 years old, the incidence is 6.6% in girls and 1.8% in boys. In school-age children, the UTI incidence is 0.7–2.3% in girls and 0.04–0.2% in boys, while it is 3% in prepubertal girls and 1% in prepubertal boys [ 2 , 11 ]. UTIs in the first year of life are associated with anatomic or functional abnormalities; however, they are uncommon in boys of this age [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Features of urinary Escherichia coli isolated from children with complicated and uncomplicated urinary tract infections in Mexico

et al. 2018

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The Hospital Infantil de México Federico Gómez (HIMFG) is a tertiary care hospital in Mexico City where Escherichia coli is frequently isolated from the urine samples of pediatric patients with urinary tract infections. A collection of 178 urinary Escherichia coli (UEc) isolates associated with complicated and uncomplicated urinary tract infections were evaluated in this study. The patterns of resistance to 9 antibiotic classes showed that 60.7% of the UEc isolates had a highly multidrug-resistant (MDR) profile. Genetic diversity analyses of the UEc isolates showed a high variability and revealed 16 clusters associated with four phylogenetic groups, namely, groups A, B1, B2, and D. Phylogenetic group B2 was widely associated with the 16 clusters as well as with virulence and fitness genes. The virulence and fitness genes in the UEc isolates, which included fimbriae-, siderophore-, toxin-, and mobility-associated genes, were grouped as occurring at a low, variable, or high frequency. Interestingly, only the papF gene could be amplified from some UEc isolates, and the sequence analysis of the pap operon identified an insertion sequence (IS) element and gene loss. These data suggested pathoadaptability and the development of immune system evasion, which was confirmed by the loss of P fimbriae-associated agglutination in the UEc isolates. E. coli clone O25-ST131 had a prevalence of 20.2% among the UEc isolates; these isolates displayed both a highly MDR profile and the presence of the papGII, fimH, papGIII, iutD, sat, hlyA, and motA genes. In conclusion, the UEc isolates from complicated urinary tract infection (cUTI) were characterized as being MDR, highly genetically diverse, and associated with phylogenetic group B2 and many virulence and fitness genes. Additionally, gene loss and IS elements were identified in some UEc isolates identified as clone O25-ST131.

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Section: Introductionmentioning

confidence: 99%

Features of urinary Escherichia coli isolated from children with complicated and uncomplicated urinary tract infections in Mexico

et al. 2018

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“…During the first 6 months, uncircumcised boys have a 10 to 12-fold increased risk of developing UTI [3, 8, 10]. In the neonatal period, UTI is more common in premature infants than term infants [11]. After one year of age, girls are much more likely than boys to develop UTI [11, 12].…”

Section: Prevalencementioning

confidence: 99%

Urinary Tract Infection in Children

Leung

Wong

Leung

et al. 2019

IAD

178

105

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Background: Urinary Tract Infection (UTI) is a common infection in children. Prompt diagnosis and appropriate treatment are very important to reduce the morbidity associated with this condition. Objective: To provide an update on the evaluation, diagnosis, and treatment of urinary tract infection in children. Methods: A PubMed search was completed in clinical queries using the key terms “urinary tract infection”, "pyelonephritis" OR "cystitis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature and the pediatric age group. Patents were searched using the key terms “urinary tract infection” "pyelonephritis" OR "cystitis" from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com. Results: Escherichia coli accounts for 80 to 90% of UTI in children. The symptoms and signs are nonspecific throughout infancy. Unexplained fever is the most common symptom of UTI during the first two years of life. After the second year of life, symptoms and signs of pyelonephritis include fever, chills, rigor, flank pain, and costovertebral angle tenderness. Lower tract symptoms and signs include suprapubic pain, dysuria, urinary frequency, urgency, cloudy urine, malodorous urine, and suprapubic tenderness. A urinalysis and urine culture should be performed when UTI is suspected. In the work-up of children with UTI, physicians must judiciously utilize imaging studies to minimize exposure of children to radiation. While waiting for the culture results, prompt antibiotic therapy is indicated for symptomatic UTI based on clinical findings and positive urinalysis to eradicate the infection and improve clinical outcome. The choice of antibiotics should take into consideration local data on antibiotic resistance patterns. Recent patents related to the management of UTI are discussed. Conclusion: Currently, a second or third generation cephalosporin and amoxicillin-clavulanate are drugs of choice in the treatment of acute uncomplicated UTI. Parenteral antibiotic therapy is recommended for infants ≤ 2 months and any child who is toxic-looking, hemodynamically unstable, immunocompromised, unable to tolerate oral medication, or not responding to oral medication. A combination of intravenous ampicillin and intravenous/intramuscular gentamycin or a third-generation cephalosporin can be used in those situations. Routine antimicrobial prophylaxis is rarely justified, but continuous antimicrobial prophylaxis should be considered for children with frequent febrile UTI.

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“…In more than 80% of cases, UTI is caused by a bacterium that the most commonly responsible organism for this bacterium is Ecoli which is part of the normal flora of the intestine [1]. The high prevalence of infection, the likelihood of recurrence of the disease, the variety of clinical symptoms in different age groups followed by the difficulty of clinical and laboratory diagnosis, the resistance of the causative agent to antibiotics and the long-term serious complications in children, have caused the infection of the urinary system to be of special importance in children [2,3] so that nowadays, UTI is one of the most common bacterial infections in children and is considered as one of the most important health indicators of communities [4].…”

Section: Introductionmentioning

confidence: 99%

“…Considering that children are the most sensitive group to infectious diseases and that the previous studies on this problem (2,3,8,9,10,14,20) that investigated the effective factors on urinary tract infection were review, survey, qualitative, prevalence measurement, and descriptive studies. This study (educational randomized controlled trial) has been conducted based on TPB and emphasizes on constructs "attitude", "perceived behavior control", "subjective norm" and "intention behavior" beside a 3 month follow-up for durability of mothers' behavior to prevent urinary tract infection in their daughters and this is the novelty of this study.…”

Section: Introductionmentioning

confidence: 99%

The effect of educational intervention program on promoting preventive behaviors of urinary tract infection in girls: a randomized controlled trial

et al. 2020

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Background: Urinary tract infection is one of the most common infectious diseases in children, which can lead to serious complications for a child. The purpose of this study was to investigate the impact of Theory Planned Behavior (TPB)-based education on the promotion of preventive behaviors of urinary tract infection in mothers with a daughter under age two. Methods: The present study is an educational randomized controlled trial that its sample consisted of 100 mothers who had a daughter under age two. They were selected through convenience sampling and then were randomly assigned to the intervention and control groups (each group included 50 participants). The data collection tool was a reliable and valid questionnaire based on TPB constructs. First, in both groups, the pre-test was administrated and then the educational intervention in the intervention group was conducted in the form of four educational sessions in 1 month (based on the pre-test need assessment) and then 3 months after the intervention (according to the ideas of Panel of Experts), post-test in both groups was administrated and then the data were analyzed through SPSS version 23 software with inferential statistics (independent t-test, paired t-test, and chi-square). The significance level was considered 0.05. Results: Three months after the intervention, the mean score of the constructs of TPB in the intervention group was significantly higher than the control group. The performance of prevention of urinary tract infection in the intervention group before the education increased from 2.85 ± 0.51 to 3.74 ± 0.29 (out of 4) (p = 0.001). Conclusions: TPB-based education with active and interventional follow-up was effective in promoting the preventive behaviors of urinary tract infection. Therefore, due to the side effects of UTI, especially in vulnerable periods such as childhood, it is recommended that trainings based on this model be carried out in other health care centers in order to maintain children health.

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Urinary Tract Infections in Infants and Children

Cited by 39 publications

References 43 publications

Features of urinary Escherichia coli isolated from children with complicated and uncomplicated urinary tract infections in Mexico

Features of urinary Escherichia coli isolated from children with complicated and uncomplicated urinary tract infections in Mexico

Urinary Tract Infection in Children

The effect of educational intervention program on promoting preventive behaviors of urinary tract infection in girls: a randomized controlled trial

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