Urinary Tract Infections: Old and New Concepts

Hellerstein, Stanley

doi:10.1016/s0031-3955(16)40092-1

Cited by 114 publications

(74 citation statements)

References 74 publications

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“…Culture results after bag specimen collection are rarely false negative, and therefore can be used as a screen for urinary tract infection; however, false positive results are frequent 6 bacteria; inadequate antiseptic methods 20 . Incomplete soap removal from the perineal skin can inhibit bacterial growth 20 .…”

Section: Discussionmentioning

confidence: 99%

Urinary tract infection in full-term newborn infants: value of urine culture by bag specimen collection

et al. 1999

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SUMMARY: Objective: to evaluate the efficacy of urine culture by bag specimen for the detection of neonatal urinary tract infection in full-term newborn infants. Retrospective study (1997) including full-term newborn infants having a positive urine culture (>100,000 CFU/ml) by bag specimen collection. The urinary tract infection diagnosis was confirmed by positive urine culture (suprapubic bladder aspiration method). The select cases were divided into three groups, according to newborn infant age at the bag specimen collection: GI (< 48 h, n = 17), GII (48 h to 7 d, n = 35) and GIII (> 7 d, n = 9). Sixty one full-term newborn infants were studied (5.1 % of total infants). The diagnosis was confirmed on 19/61 (31.1 %) of full-term infants born alive. Distribution among the groups was: GI = 2/17 (11.8 %), GII = 10//35 (28.6 %), and GIII = 7/9 (77.7 %). The most relevant clinical symptoms were: fever (GI -100 %, GII -91.4 %) and weight loss (GI -35.3 %, GII -45.7 %). Urine culture results for specimens collected by suprapubic aspiration were: E. coli GI (100 %), GII (40 %) and GIII (28.6 %), E. faecalis GI (30%), Staphylococcus coagulase-negative GII (20 %) and GIII (42.8 %), and Staphylococcus aureus GII (10 %). Correlation between positive urine culture collection (bag specimen method) and urinary tract infection diagnosis, using relative risk analysis, produced the following results: GI=0.30 (CI95% 0.08-1.15), GII=0.51 (CI 95% 0.25-1.06) and GIII=3.31 (CI95% 1.8-6.06) The most frequent urinary tract infection clinical signs in the first week were fever and weight loss, while non-specific symptomatology occurred later. E. coli was most frequent infectious agent, although from the 7th day of life, staphylococcus was noted. The urine culture (bag specimen method) was effective in detecting urinary tract infection only after the 7th day of life. DESCRIPTORS: Urine culture. Urinary tract infection. Newborn infant.

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Section: Discussionmentioning

confidence: 99%

Urinary tract infection in full-term newborn infants: value of urine culture by bag specimen collection

et al. 1999

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“…3,4 A more relevant question should be, "What is the probability of clinically significant VUR with a low chance of spontaneous resolution?" Factors affecting spontaneous resolution include age, gender, initial grade of VUR, renal scarring, bowel-bladder dysfunction, and bladder volume at onset of VUR.…”

Section: What Is the Probability Of Vur?mentioning

confidence: 99%

“…2 Of children presenting with febrile UTIs, 25-40% are found to have vesicoureteral reflux (VUR). 3,4 Historically, the default concern was that children with any degree of VUR had a substantially increased risk for recurrent pyelonephritis and secondary renal damage with sequelae of scarring, hypertension, and end-stage renal disease. 5 This led to investigation and treatment for all.…”

Section: Introductionmentioning

confidence: 99%

The role of voiding cystourethrography in the investigation of children with urinary tract infections

Lee

Lorenzo

Koyle

2016

CUAJ

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Urinary tract infections (UTIs) represent a common bacterial cause of febrile illness in children. Of children presenting with a febrile UTI, 25-40% are found to have vesicoureteral reflux (VUR). Historically, the concern regarding VUR was that it could lead to recurrent pyelonephritis, renal scarring, hypertension, and chronic kidney disease. As a result, many children underwent invasive surgical procedures to correct VUR. We now know that many cases of VUR are low-grade and have a high rate of spontaneous resolution. The roles of surveillance, antibiotic prophylaxis, endoscopic injection, and ureteral reimplantation surgery also continue to evolve. In turn, these factors have influenced the investigation of febrile UTIs.Voiding cystourethrography (VCUG) is the radiographic test of choice to diagnose VUR. Due to its invasive nature and questionable benefit in many cases, the American Academy of Pediatrics (AAP) no longer recommends VCUG routinely after an initial febrile UTI. Nevertheless, these guidelines pre-date the landmark Randomized Intervention of Children with Vesicoureteral Reflux (RIVUR) trial and there continues to be controversy regarding the diagnosis and management of VUR. This paper discusses the current literature regarding radiographic testing in children with febrile UTIs and presents a practical risk-based approach for deciding when to obtain a VCUG.

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“…A single parenteral dose may be used in cases of doubtful compliance and with a normal urinary tract (Khan, 1994). If the response is poor or complications develop, the child must be admitted to hospital for parenteral treatment (Hellerstein, 1995). There is no consensus regarding the treatment of pediatric candiduria.…”

Section: Treatmentmentioning

confidence: 99%

Current Management of Urinary Tract Infection in Children

Kïbar¹

2011

Urinary Tract Infections

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Urinary Tract Infections: Old and New Concepts

Cited by 114 publications

References 74 publications

Urinary tract infection in full-term newborn infants: value of urine culture by bag specimen collection

Urinary tract infection in full-term newborn infants: value of urine culture by bag specimen collection

The role of voiding cystourethrography in the investigation of children with urinary tract infections

Current Management of Urinary Tract Infection in Children

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