Clinical Spectrum of Recurrent Urinary Tract Infections in Children Recurrent Urinary Tract Infections in Children
Journal of Pediatric Nephrology,
Vol. 10 No. 4 (2022),
15 March 2023
https://doi.org/10.22037/jpn.v10i4.41116
Abstract
Background and Aim: Urinary tract infection (UTI), is a common bacterial infection in
pediatric group, can be easily diagnosed, but its recurrence can indicate underlying serious
anatomical defects of the urogenital tract, leading to acute morbidity and chronic medical
condition, such as hypertension and renal insufficiency.
Objective: To know the clinical spectrum and the frequency of recurrent UTI among children
visiting our hospital.
Methods: This prospective study was conducted during the period from April 2020 to March
2021, in the department of pediatrics and pediatric nephrology, Governmental Medical
College, Srinagar. All children aged between 6 months to 18 years presenting with a history
of recurrent urinary tract were included in the study. A detailed history, relevant clinical
examination, and the ultrasonography of kidney ureters and bladder (USG KUB) followed
by voiding cystourethrography (VCUG), were carried out and subsequently analyzed.
Results: A total of 38 patients with recurrent UTI were evaluated during one year. The
commonest age group was 6 months to 2 years (68%), with female preponderance (F: M
3.2:1). Urine culture grew E. coli in 95% of patients, while USG abnormalities and the
presence of vesicoureteral reflux (VUR) on voiding cystourethrography (VCUG) were seen
in 14 patients (36%).
Conclusion: Recurrent UTI are common between 6 months to 2 years, and E coli is the most
common cause. Children with the past history of UTI seem more predisposed to have another
E.coli-associated UTI.
- children
- Urine culture
- Urinary tract infection (UTI)
- Vesicoureteral reflux
How to Cite
References
Hellström A, Hanson E, Hansson S, Hjälmås K, Jodal U. Association
between urinary symptoms at 7 years old and previous
urinary tract infection. Arch Dis Child. 1991; 66:232-4.
[DOI:10.1136/adc.66.2.232] [PMID] [PMCID]
Winberg J, Bergström T, Jacobsson B. Morbidity, age and sex
distribution, recurrences and renal scarring in symptomatic
urinary tract infection in childhood. Kidney Int Suppl. 1975
Aug;4:S101-6. [PMID]
Panaretto KS, Craig JC, Knight JF, Howman Giles R, Sureshkumar
P, Roy LP. Risk factors for recurrent urinary tract infection
in preschool children.J Paediatr Child Health. 1999;
:454-9. [DOI:10.1046/j.1440-1754.1999.355417.x] [PMID]
Bisset GS, III, Strife JL, Dunbar JS. Urography and voiding
cystourethrography: Findings in girls with urinary tract infection.
AJR Am J Roentgenol. 1987; 148:479-2. [DOI:10.2214/
ajr.148.3.479] [PMID]
Gleeson FV, Gordon I. Imaging in urinary tract infection.
Arch Dis Child. 1991; 66:1282-3. [DOI:10.1136/adc.66.11.1282]
[PMID] [PMCID]
Shaikh N, Hoberman A, Wise B, Kurs-Lasky M, Kearney
D, Naylor S et al. Dysfunctional elimination syndrome: Is it
related to urinary tract infection or vesicoureteral reflux diagnosed
early in life? Pediatrics. 2003; 112:1134-7. [DOI:10.1542/
peds.112.5.1134] [PMID]
Svanborg C. Urinary tract infections in children: Microbial
virulence versus host susceptibility. Adv Exp Med Biol. 2013;
:205-10. [DOI:10.1007/978-1-4614-4726-9_17] [PMID]
Ragnarsdóttir B, Svanborg C. Susceptibility to acute pyelonephritis
or asymptomatic bacteriuria: Host-pathogen
interaction in urinary tract infections. Pediatr Nephrol. 2012;
:2017-9. [DOI:10.1007/s00467-011-2089-1] [PMID]
Craig JC, Irwig LM, Knight JF, Sureshkumar P, Roy LP.
Symptomatic urinary tract infection in preschool Australian
children. Journal of Paediatrics & Child Health 1998;
(2):154-9. [DOI:10.1046/j.1440-1754.1998.00190.x] [PMID]
Coulthard MG, Lambert HJ, Keir MJ. Occurrence of renal
scars in children after their first referral for urinary tract infection.
BMJ. 1997; 315:918-9. [DOI:10.1136/bmj.315.7113.918]
[PMID] [PMCID]
Conway PH, Cnaan A, Zaoutis T, Henry BV, Grundmeier
RW, Keren R. Recurrent urinary tract infections in children:
Risk factors and association with prophylactic antimicrobials.
JAMA. 2007; 298:179-86. [DOI:10.1001/jama.298.2.179]
[PMID]
Heikel PE, Parkkulainen KV. Vesico-ureteric reflux in children.
A classification and results of conservative treatment.
Ann Radiol. 1966; 9(1):37-40. [PMID]
Saadeh SA, Matto TK. Managing urinary tract infections.
Paediatr Nephrol. 2011; 26:1967-76. [DOI:10.1007/s00467-011-
-5] [PMID] [PMCID]
Hannula A, Venhola M, Renko M, Pokka T, Huttunen NP,
Uhari M. Vesicoureteral reflux in children with suspected and
proven urinary tract infection. Pediatr Nephrol. 2010; 25(8):
-9. [DOI:10.1007/s00467-010-1542-x] [PMID]
Alberici I, La Manna A, Pennesi M, Starc M, Scozzola F,
Nicolini G et al. First urinary tract infections in children: The
role of the risk factors proposed by the Italian recommendations.
Italian recommendations. Acta Paediatrica. 2018;
(3):544-50. [DOI:10.1111/apa.14506] [PMID]
Morello W, La Scola C, Alberici I, Montini G. Acute pyelonephritis
in children. Pediatr Nephrol. 2016; 31(8):1253-65.
[DOI:10.1007/s00467-015-3168-5] [PMID]
Williams G, Hodson EM, Craig JC. Interventions for primary
vesicoureteric reflux. Cochrane Database Syst Rev. 2019;
(2):CD001532. [DOI:10.1002/14651858.CD001532.pub5]
Venhola M, Huttunen NP, Uhari M. Meta-analysis
of vesicoureteral reflux and urinary tract infection
in children. Scand J Urol Nephrol. 2006; 40:98-102.
[DOI:10.1080/00365590500499529] [PMID]
Jacobson SH, Eklo¨f O, Eriksson CG, Lins LE, Tidgren B,
Winberg J. Development of hypertension and uraemia after
pyelonephritis in childhood: 27 year follow up. BMJ. 1989;
(6701):703-6. [DOI:10.1136/bmj.299.6701.703] [PMID]
[PMCID]
Goonasekera CD, Shah V, Wade AM, Barratt TM, Dillon
MJ. 15-year follow-up of renin and blood pressure in reflux
nephropathy. Lancet. 1996; 347(9002):640-3. [DOI:10.1016/
S0140-6736(96)91201-5] [PMID]
Wennerstrom M, Hansson S, Hedner T, Himmelmann A,
Jodal U. Ambulatory blood pressure 16-26 years after the first
urinary tract infection in childhood. J Hypertens. 2000; 18:485-
[DOI:10.1097/00004872-200018040-00019] [PMID]
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