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Journal articles on the topic 'Urinary tract infections in children'

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Published: 4 June 2021

Last updated: 30 July 2024

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1

Rokkam, Bhavani Shankar, Chowdary Babu Menni, Ramu Pedada, and Deepak Kumar Alikana. "Clinical, Epidemiological and Bacteriological Profile of Culture Positive Urinary Tract Infections in Febrile Children – A Cross Sectional Study." Journal of Evidence Based Medicine and Healthcare 8, no. 10 (March 8, 2021): 522–26. http://dx.doi.org/10.18410/jebmh/2021/102.

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BACKGROUND Urinary tract infections (UTI) constitute a common cause of morbidity in infants and children. When associated with abnormalities of urinary tract, they may lead to long-term complications including renal scarring, loss of function and hypertension. Most urinary tract infections remain undiagnosed if investigations are not routinely performed to detect them. Prompt detection and treatment of urinary tract infections and any complicating factors are important. The objective of the study is to know the clinical, epidemiological and bacteriological profile (i.e. clinical signs and symptoms, age, sex, family history, associated urinary tract abnormalities, & causative organisms) of urinary tract infections in febrile children with culture positive urinary tract infection. METHODS This descriptive, cross sectional observational study was conducted at outpatient clinics of our “child health clinics” between May 2016 and April 2017 (one year). All children aged 0 to 12 years with culture positive urinary tract infections were included in this study to evaluate the clinical, epidemiological and bacteriological profile. RESULTS A total of 69 children with culture positive urinary tract infections were included in this study. Out of 69 children included in this study, 36 (52.2 %) were females and 33 (47.8 %) were males. Overall female preponderance was seen and the M: F ratio was 0.9:1. But during first year of life in our study group we had more boys (10, 14.49 %) affected with urinary tract infection than girls. 49.3 % of urinary tract infections in the present study belonged to lower socio-economic status. Most common organism causing urinary tract infection in our group was E. coli (56.5 %). Fever (100 %), anorexia or refusal of feeds (52.2 %), dysuria (46.4 %), vomiting (46.4 %) and abdominal pain (39.1 %) were the predominant clinical manifestations observed in our study. CONCLUSIONS Urinary tract infection is a common medical problem in children and it should be considered as a potential cause of fever in children. As febrile children with urinary tract infection usually present with non-specific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. KEYWORDS Urinary Tract Infections (UTI), Febrile Children, Bacteriological Profile, Urine Culture

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Wojtachnio, Dominika, Aleksandra Osiejewska, Jakub Bartoszewicz, Anna Grądzik, Izabela Nowakowska, Małgorzata Kudan, Anna Gorajek, and Karolina Mikut. "Urinary tract infections in children - a review." Journal of Education, Health and Sport 12, no. 9 (September 14, 2022): 773–82. http://dx.doi.org/10.12775/jehs.2022.12.09.091.

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Introduction and purpose: Urinary tract infection (UTI) is very common, mostly bacterial infection in childhood. UTI may affect the lower urinary tract or the upper urinary tract. Infection typically require antibiotics for treatment. Brief description of the state of knowledge: The prevalence of urinary tract infection is between 2 and 8% and it is more common in female, infants and uncircumcised male infants. Most paediatric UTIs are caused by Gram negative bacteria Escherichia coli (E.coli). Symptoms of this infection are nonspecific and may be confused with signs of other clinical conditions. The most common symptoms are suprapubic pain, back pain, dysuria, urinary frequency and systemic symptoms such as fever, vomiting, lethargy. Antibiotics are the standard treatment for urinary tract infections. Conclusion: This article reviews basic informations, epidemiology, clinical presentation, diagnosis and treatment of urinary tract infection.

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ME, Parlak. "A Review of Urinary Tract Infections in Pediatric Patients." Open Access Journal of Urology & Nephrology 8, no. 3 (July 14, 2023): 1–11. http://dx.doi.org/10.23880/oajun-16000238.

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Urinary tract infections (UTIs) are a common and significant health concern in children. The etiology of UTIs in children can vary depending on various factors, including age, gender, and underlying conditions. This comprehensive review aims to explore the etiology, pathogens involved, etiological evaluation by age group, diagnosis, differential diagnosis, follow-up, treatment, and prognosis of UTIs in children. Introduction: Urinary tract infections (UTIs) are bacterial infections that affect the urinary system, comprising the kidneys, ureters, bladder, and urethra. In children, UTIs can cause substantial morbidity if not promptly diagnosed and treated. Understanding the etiology and appropriate management strategies is crucial for healthcare providers involved in the care of pediatric patients. Etiology of UTIs in Children: UTIs in children can have various etiological factors, with the most common cause being bacterial invasion of the urinary tract. The majority of UTIs are caused by Gram-negative bacteria, with Escherichia coli being the predominant pathogen. Other potential pathogens include Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus saprophyticus. Viral and fungal infections can also contribute to UTIs in certain cases. Pathogens Involved in the Etiology of UTIs: A detailed examination of the pathogens involved in UTIs is essential for appropriate diagnosis and treatment. E. coli, which colonizes the gastrointestinal tract, is responsible for the majority of UTIs in children. Understanding the antibiotic resistance patterns of these pathogens is crucial in selecting appropriate antimicrobial therapy. Etiological Evaluation by Age Group: The etiological evaluation of UTIs in children varies according to age group. Infants, young children, and older children may exhibit different risk factors and underlying conditions that contribute to UTIs. An age-specific approach is necessary to identify the potential causes, such as urinary tract abnormalities, voiding dysfunction, or anatomical abnormalities. Diagnosis of UTIs in Children: Accurate and timely diagnosis of UTIs is crucial to prevent complications and recurrent infections. Various diagnostic tools, including urinalysis, urine culture, and imaging studies, aid in identifying UTIs and determining the severity of infection. Clinical symptoms, such as fever, dysuria, and urinary frequency, must also be considered in the diagnostic process. Differential Diagnosis: UTIs can present with symptoms similar to other conditions, leading to diagnostic challenges. Differential diagnoses may include conditions such as pyelonephritis, urinary tract stones, urethritis, and sexually transmitted Open Access Journal of Urology & Nephrology 2 Parlak ME and Kucukkelepce O. A Review of Urinary Tract Infections in Pediatric Patients. J Urol Nephrol 2023, 8(3): 000238. Copyright© Parlak ME and Kucukkelepce O. infections. An understanding of these potential differentials is essential to avoid misdiagnosis and provide appropriate treatment. Follow-up and Monitoring: After initiating treatment for UTIs, regular follow-up and monitoring are necessary to ensure the resolution of infection, assess treatment response, and prevent complications. Monitoring urine culture results, renal function, and imaging studies play a vital role in evaluating the effectiveness of treatment and detecting any underlying conditions that require further management. Treatment of UTIs in Children: Treatment of UTIs in children involves antimicrobial therapy targeted at the identified pathogen. The choice of antibiotics should consider local resistance patterns, age of the child, and severity of infection. Adequate hydration, symptomatic relief, and addressing predisposing factors are also important in the overall management of UTIs. Prognosis: With timely diagnosis and appropriate treatment, the prognosis for UTIs in children is generally favorable. However, the presence of underlying conditions, delayed diagnosis, or recurrent infections can influence the long-term outcome. Identifying and managing risk factors and promoting good urinary hygiene can help prevent future UTIs and potential complications. Conclusion: Urinary tract infections in children present unique challenges in terms of etiology, diagnosis, and management. Understanding the etiological factors, pathogens involved, appropriate diagnostic approaches, and treatment strategies is crucial for healthcare providers. By implementing a comprehensive approach that considers age-specific evaluations, accurate diagnosis, and effective treatment, healthcare professionals can ensure optimal outcomes and reduce the burden of UTIs in children.

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Balighian, Eric, and Michael Burke. "Urinary Tract Infections in Children." Pediatrics in Review 39, no. 1 (January 2018): 3–12. http://dx.doi.org/10.1542/pir.2017-0007.

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5

Osuch, Elzbieta, and Andre Marais. "Urinary tract infections in children." South African Family Practice 60, no. 1 (January 18, 2018): 35–40. http://dx.doi.org/10.4102/safp.v60i1.4782.

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Urinary tract infections (UTIs) are common in childhood and represent approximately 10% of hospital-acquired infections. It is clinically challenging to distinguish cystitis (lower UTI) from pyelonephritis (upper UTI) in those younger than two years. Most UTI patients can however be safely managed as outpatients if diligent follow-up procedures are in place. Recurrent UTIs in children may indicate malfunction or an anatomical defect of the urinary tract, and require specialised diagnostic studies. The proper approach for a child with UTI remains controversial, and treatment often differs according to regional or institutional empirical guidelines.

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Shishimorov, I. N., O. V. Magnitskaya, O. V. Shatalova, N. F. Shaposhnikova, and M. M. Koroleva. "URINARY TRACT INFECTIONS IN CHILDREN." Journal of Volgograd State Medical University 74, no. 2 (June 30, 2020): 3–8. http://dx.doi.org/10.19163/1994-9480-2020-2(74)-3-8.

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The review addresses the main issues related to the rational pharmacotherapy of urinary tract infection (UTI). UTIs are a common and important clinical problem in children. Among UTI causative agents in children are dominated by gram-negative bacteria, E. coli. According to modern clinical guidelines, the leading direction in the treatment of UTI in children is antibiotic therapy, which should be prescribed taking into account the sensitivity of microorganisms. Drugs of choice for UTI in children: cephalosporins or protected aminopenicillins

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King, R. "Urinary Tract Infections in Children." Emergency Medicine News 24, no. 2 (February 2002): 14. http://dx.doi.org/10.1097/00132981-200202000-00010.

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Lerner, Gary P. "Urinary Tract Infections in Children." Pediatric Annals 23, no. 9 (September 1, 1994): 463–73. http://dx.doi.org/10.3928/0090-4481-19940901-05.

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9

Watkins, Jean. "Urinary tract infections in children." Practice Nursing 18, no. 10 (October 2007): 516. http://dx.doi.org/10.12968/pnur.2007.18.10.27442.

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10

Rushton, H. Gil. "URINARY TRACT INFECTIONS IN CHILDREN." Pediatric Clinics of North America 44, no. 5 (October 1997): 1133–69. http://dx.doi.org/10.1016/s0031-3955(05)70551-4.

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11

Winberg, Jan. "Urinary tract infections in children." Current Opinion in Infectious Diseases 3, no. 1 (February 1990): 55–61. http://dx.doi.org/10.1097/00001432-199002000-00012.

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Tullus, Kjell, and Nader Shaikh. "Urinary tract infections in children." Lancet 395, no. 10237 (May 2020): 1659–68. http://dx.doi.org/10.1016/s0140-6736(20)30676-0.

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13

Jadresić, Lyda. "Urinary tract infections in children." Paediatrics and Child Health 24, no. 7 (July 2014): 289–92. http://dx.doi.org/10.1016/j.paed.2013.11.002.

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Prajapati, Hitesh. "Urinary tract infections in children." Paediatrics and Child Health 28, no. 7 (July 2018): 318–23. http://dx.doi.org/10.1016/j.paed.2018.04.009.

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15

Flashner, Steven C. "Urinary tract infections in children." Current Opinion in Urology 2, no. 6 (December 1992): 423–25. http://dx.doi.org/10.1097/00042307-199212000-00005.

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Rushton, H. Gil. "Urinary tract infections in children." Current Opinion in Urology 5, no. 6 (November 1995): 280–89. http://dx.doi.org/10.1097/00042307-199511000-00003.

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Riccabona, Marcus. "Urinary tract infections in children." Current Opinion in Urology 13, no. 1 (January 2003): 59–62. http://dx.doi.org/10.1097/00042307-200301000-00010.

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Sedberry-Ross, Sherry, and Hans G. Pohl. "Urinary tract infections in children." Current Urology Reports 9, no. 2 (March 2008): 165–71. http://dx.doi.org/10.1007/s11934-008-0029-9.

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Marsh, Melanie C., Guillermo Yepes Junquera, Emily Stonebrook, John David Spencer, and Joshua R. Watson. "Urinary Tract Infections in Children." Pediatrics in Review 45, no. 5 (May 1, 2024): 260–70. http://dx.doi.org/10.1542/pir.2023-006017.

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Despite the American Academy of Pediatrics guidelines for the evaluation, treatment, and management of urinary tract infections (UTIs), UTI diagnosis and management remains challenging for clinicians. Challenges with acute UTI management stem from vague presenting signs and symptoms, diagnostic uncertainty, limitations in laboratory testing, and selecting appropriate antibiotic therapy in an era with increasing rates of antibiotic-resistant uropathogens. Recurrent UTI management remains difficult due to an incomplete understanding of the factors contributing to UTI, when to assess a child with repeated infections for kidney and urinary tract anomalies, and limited prevention strategies. To help reduce these uncertainties, this review provides a comprehensive overview of UTI epidemiology, risk factors, diagnosis, treatment, and prevention strategies that may help pediatricians overcome the challenges associated with acute and recurrent UTI management.

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Okarska-Napierała, Magdalena, Katarzyna Karpierz, Przemysław Bombiński, Piotr Majcher, Adam Waszkowski, and Ernest Piotr Kuchar. "The impact of childhood febrile urinary tract infection on urinary tract dilation in ultrasonography." Pediatria i Medycyna Rodzinna 19, no. 2 (August 28, 2023): 97–101. http://dx.doi.org/10.15557/pimr.2023.0016.

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Introduction and objective: Febrile urinary tract infection in a child may be the first manifestation of congenital anomalies of the kidneys and the urinary tract. Renal and bladder ultrasonography remains the first-line imaging modality in children with urinary tract infections. Urinary tract dilation found on ultrasonography prompts further invasive diagnosis; however, when performed in the acute phase of infection, it may potentially reveal misleading findings. Our study investigated whether acute urinary tract infection is associated with urinary tract dilatation and kidney oedema on ultrasonography. Materials and methods: We included 62 children up to 3 years of age with the first episode of febrile urinary tract infection in this prospective cohort study. We performed three ultrasonography examinations in each child: on the first day of the treatment, as well as two and four weeks after treatment onset. We scanned 124 kidneys. Results: The number of kidneys with urinary tract dilation has not significantly changed in consecutive ultrasound examinations. However, both renal length and width increased in the acute phase of urinary tract infection, correlating with symptom duration and C-reactive protein levels, and then subsided within 2–4 weeks. Conclusions: Febrile urinary tract infection does not significantly affect the results of renal and bladder ultrasonography for congenital anomalies of the kidneys and the urinary tract in children up to 3 years old. Kidneys are often involved in children with febrile urinary tract infections. Repeated ultrasound scans before further, more invasive diagnosis are recommended.

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Ruberto, U., P. D'Eufemia, F. Martino, and O. Giardini. "Amoxycillin and Clavulanic Acid in the Treatment of Urinary Tract Infections in Children." Journal of International Medical Research 17, no. 2 (March 1989): 168–71. http://dx.doi.org/10.1177/030006058901700209.

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The efficacy of amoxicillin–clavulanic acid combination in the treatment of urinary tract infections resistant, in vitro, to amoxycillin was studied in 42 children. Of the 24 children with urinary tract infection for the first time, combination therapy, dosing twice daily for 5 days (40 mg/kg·day), cleared the infection in 23 (96%) cases. Relapse occurred in four (17%) cases within 30 days. Of the 18 children who presented with recurrent urinary tract infections therapy, as above, cleared the infection in 16 (89%) cases. In these cases, long-term therapy was performed at a dosage of 20 mg/kg once daily. Tolerance was good; gastro-intestinal disorders in five (12%) cases which regressed by dosing at 8 h rather than 12 h intervals. In conclusion, amoxycillin–clavulanic acid can be considered a first choice treatment of urinary tract infections in children.

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Montini, Giovanni, Kjell Tullus, and Ian Hewitt. "Febrile Urinary Tract Infections in Children." New England Journal of Medicine 365, no. 3 (July 21, 2011): 239–50. http://dx.doi.org/10.1056/nejmra1007755.

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Davis, A., B. Obi, and M. Ingram. "Investigating urinary tract infections in children." BMJ 346, jan30 1 (January 30, 2013): e8654-e8654. http://dx.doi.org/10.1136/bmj.e8654.

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GILL, MICHELLE A., and GORDON E. SCHUTZE. "Citrobacter urinary tract infections in children." Pediatric Infectious Disease Journal 18, no. 10 (October 1999): 889–92. http://dx.doi.org/10.1097/00006454-199910000-00010.

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Montgomery, Diane F., Deborah K. Parks, and Robert J. Yetman. "Managing urinary tract infections in children." Journal of Pediatric Health Care 12, no. 5 (September 1998): 268–70. http://dx.doi.org/10.1016/s0891-5245(98)90209-7.

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Malhotra, Sameer M., and William A. Kennedy. "Urinary tract infections in children: treatment." Urologic Clinics of North America 31, no. 3 (August 2004): 527–34. http://dx.doi.org/10.1016/j.ucl.2004.04.013.

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Maskell, R. "Managing urinary tract infections in children." BMJ 298, no. 6668 (January 28, 1989): 253–54. http://dx.doi.org/10.1136/bmj.298.6668.253-c.

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Conway, Patrick H., Avital Cnaan, Theoklis Zaoutis, Brandon V. Henry, Robert W. Grundmeier, and Ron Keren. "Recurrent Urinary Tract Infections in Children." JAMA 298, no. 2 (July 11, 2007): 179. http://dx.doi.org/10.1001/jama.298.2.179.

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Tasmia, Amir Muhammad, Bakht Beland, and Abbas Zarin. "Evaluation of Routine Urine Analysis in Diagnosing Urinary Tract Infection among Pediatric Population: A Validation Study." Journal of Saidu Medical College, Swat 14, no. 1 (March 8, 2024): 30–34. http://dx.doi.org/10.52206/jsmc.2024.14.1.831.

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Background: Urinary tract infection (UTI) stands out as one of the most common bacterial infections affecting children below the age of five. A valid diagnostic test for UTI is of utmost importance for avoiding bacterial resistance.Objectives: To assess the diagnostic efficacy of routine urine examinations in detecting urinary tract infections in pediatric patients, employing urine culture as the reference standardMaterial and Methods: This diagnostic study was conducted at leady reading hospital, Peshawar. The study employed a non-probability consecutive sampling technique and included 130 children between the ages of 1 and 5 years, regardless of gender, who exhibited symptoms suggestive of urinary tract infections. Exclusion criteria comprised children who had taken antibiotics within the past 48 hours, those with congenital renal anomalies such as renal or renal tumors, renal tract obstruction, and acute renal failure. All participants underwent urine regular examination and urine culture. Sensitivities, specificities, and accuracy were calculated, and the data was further stratified based on gender and age.Results: The mean age of the participants was 2.646±1.32 years. The males were predominant (n-86, 66.2%). The urine examination demonstrated a specificity of 90.91% and a sensitivity of 58.06% in detecting urinary tract infections. A statistically significant difference was observed when comparing the diagnosis of Urinary tract infections using urine culture and urine examination.Conclusion: While urine examinations exhibit satisfactory specificity, their sensitivity is insufficient to be utilized as a reliable diagnostic test for detecting urinary tract infections in children. Clinicians are advised to depend on urine culture for accurate diagnosis in such cases.Keywords: Diagnostic accuracy, Pediatrics, Urine Microbiology, Urinalysis, Urinary tract infection.

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Al-naddawi, Mahjoob N., and Muneera F. Rida. "Radiological finding in pediatric patients with urinary tract infections." Journal of the Faculty of Medicine Baghdad 53, no. 3 (October 2, 2011): 257–60. http://dx.doi.org/10.32007/jfacmedbagdad.533824.

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Background; determining what radiologic studies to obtain following the diagnosis of a urinary tract infection(uti) is an area of medicine that is still not agreed upon, nor is there a gold standard.Objective; to study the radiological abnormalities in paediatric patients with urinary tract infections.Patients and methods; this prospective study was done from the first of june 2008 to the first of may 2009 include 104 pediatric patients who were referred to children welfare hospital ,(pediatric nephrological out patient clinic) with signs and symptoms of urinary tract infections, all of them had culture positive urine examination , ultrasonograhy was done for all patients, voiding cystouretherography was done for patients with recurrent attacks of urinary tracts infections (58 patients),and intravenous urography was done for patients with urinary tract abnormalities on ultrasonography (41patients).Results; the results of the present study showed that about 63( 59.4%)of infants and children with (culture positive) urinary tract infections had positive ultrasonic findings ,the most frequent ultrasonic findings was pelvicalyceal and ureteral dilatation whichwas observed in 32.6%. Thirty four(32.6% )of patients had positive findings on voiding cystography ,( grade 5&4 reflux found in 22.4%). The intravenous urography study was beneficial in diagnosis of pelviureteric junction obstruction in 12.2% and visualized the obstructive effect of renal and ureteric stones in 24.4%.Conclusion; the positive radiological findings supported the idea that the patients with recurent urinary tract infections need imaging work up.

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Bezruk, V. V., and D. D. Ivanov. "Improving medical standards of care to children of an early and preschool age with urinary tract infections at the primary care stage." KIDNEYS 10, no. 4 (January 19, 2022): 196–200. http://dx.doi.org/10.22141/2307-1257.10.4.2021.247894.

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Timely diagnosis, prognostic value of clinical signs and further treatment of patients of an early age with urinary tract infections (UTI) during outpatient stage are important constituents of an integrated management of patients in childhood. The article deals with new approaches concerning clinical algorithm in diagnosis of urinary tract infections in children. The algorithm of diagnostic and therapeutic measures for providing care to children under 5 years of age with urinary tract infections, in particular at the stage of primary care, includes: diagnosis of urinary tract infection in young children using The Diagnosis of Urinary Tract infection in Young children, patient’s examination by Gorelick Scale and UTIcalc, imaging methods with mandatory ultrasound of the kidneys and bladder, micturating cystogram after the first episode of infection in boys and the second — in girls, the prescription of antibiotic therapy based on data from regional monitoring of antibiotic resistance of the main groups of uropathogens, monitoring antibiotic resistance using electronic means and the implementation in microbiological laboratories of the guidelines of the European Committee on Antimicrobial Susceptibility Testing, as well as introduction of the prescription sale of antibiotics.

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Lembryk, I. S., I. V. Shlimkevych, A. B. Stefanyshyn, O. V. Zhyliak, and N. I. Kostyrko. "Features of pyelonephritis course in adolescent females with co-existing anаemic syndrome." CHILD`S HEALTH 18, no. 6 (November 5, 2023): 423–29. http://dx.doi.org/10.22141/2224-0551.18.6.2023.1629.

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Background. Anaemic syndrome of complex origin is not uncommon in urinary tract infection, particularly in dietary non-adherence, menstrual cycle disorders, or concomitant digestive diseases, recurrent respiratory infections, etc. However, there is currently insufficient epidemiological data on this comorbidity in the literature. This study aims to establish the features of pyelonephritis course in its combination with anaemic syndrome in children. Materials and methods. We analysed the medical records of 200 children aged 0 to 17 years with acute non-complicated pyelonephritis, complicated and recurrent urinary tract infections for 2012–2017. In the second stage of our work, we comprehensively examined 85 girls aged 11 to 17 who underwent inpatient treatment between 2018 and March 2023. Thirty children of the same age and gender made up the comparison group. A paediatric gastroenterologist, a paediatric gynaecologist and/or urologist examined all patients. Immunochemical method with electrochemiluminescence immunoassay was used to assess ferritin content; also, serum iron and total iron-binding capacity were measured. Results. Anaemic syndrome is common in most girls with urinary tract infections (58.8 % of сases). Among the causes, the following are distinguished: menstrual cycle disorders with abnormal uterine bleeding (50.0 %), chronic digestive disorders, in particular malabsorption syndrome of unknown origin (25.0 %), recurrent bronchopulmonary disorders (15.0 %), and unbalanced diet (10.0 %). The features of urinary tract infections and concomitant iron deficiency in children include fatigue (55.0 % in acute non-complicated pyelonephritis vs. 40.0 % in complicated urinary tract infections, р < 0.05), dizziness (35.0 % in acute non-complicated pyelonephritis vs. 15.0 % in recurrent urinary tract infections, χ2 = 48.6532, р < 0.05), and pallor (25.0 % in complicated urinary tract infections vs. 10 % in recurrent urinary tract infections, χ2 = 0.7168, р > 0.05). The ferritin level was the highest in patients with complicated urinary tract infections (18.2 µg/mL). In patients with recurrent urinary tract infections, this indicator was the lowest — 5.0 µg/mL. Conclusions. Retrospective analysis of medical records confirmed the presence of anaemia in 30.0 % of girls with inflammatory kidney diseases. During the physical examination, 58.8 % of female adolescents with urinary tract infections had signs of anaemic syndrome.

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Amatya, Puja, Suchita Joshi, and Shrijana Shrestha. "Culture and Sensitivity Pattern of Urinary Tract Infection in Hospitalized Children in Patan Hospital." Journal of Nepal Paediatric Society 36, no. 1 (October 22, 2016): 28–33. http://dx.doi.org/10.3126/jnps.v36i1.14629.

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Introduction: Urinary tract infection is one of the most common infections in children. Antibiotics are usually given empirically before urine culture reports are available. The primary aim of this study was to see the causative organisms and culture and sensitivity pattern of urinary tract infection in hospitalized children.Material and Methods: All children aged 0-15 years with culture positive urinary tract infections who were admitted to children’s ward from 14th April 2013 to 14th April 2014 were included. The causative organisms for urinary tract infection along with its antibiotic sensitivity pattern were retrospectively reviewed and analyzed.Results: 48 cases of culture positive urinary tract infection were enrolled in this study in a period of 12 months. The most common causative organism was Escherichia coli (67%), followed by Klebsiella pneumoniae (21%), Non-hemolytics streptococcus (4%), Enterobacter (2%), Acinetobacter (2%), Proteus (2%) and Coagulase negative staphylococcus (2%). Most cases of the culture positive urinary tract infection occurred between 2 months to 1 year of age. Out of 48 cases, 90% were sensitive to Amikacin and 85% were resistant to Ofloxacin.Conclusion: Escherichia coli is the most common organism causing urinary tract infection in children. As resistant to first line antibiotic is increasing, antibiotic stewardship programme should be strengthened.J Nepal Paediatr Soc 2016;36(1):28-33

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Hadjipanayis, Adamos, Zachi Grossman, Stefano del Torso, Diego van Esso, Hans Juergen Dornbusch, Artur Mazur, Anna Drabik, and Giovanni Montini. "Current primary care management of children aged 1–36 months with urinary tract infections in Europe: large scale survey of paediatric practice." Archives of Disease in Childhood 100, no. 4 (November 5, 2014): 341–47. http://dx.doi.org/10.1136/archdischild-2014-306119.

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ObjectiveTo describe current practice among European paediatricians regarding diagnosis and management of urinary tract infections in children aged 1–36 months and to compare these practices with recently published guidelines.DesignWeb-based large scale survey evaluating knowledge of, attitudes towards and the methods for diagnosing, treating and managing urinary tract infections in children.SettingPrimary and secondary care practices in Europe.Sample1129 paediatricians.ResultsA diagnosis of urinary tract infection is considered by 62% of the respondents in children aged 1–36 months with unexplained fever. The preferred method of urine collection is use of a bag (53% for infants <3 months and 59% for children 4–36 months of age). 60% of paediatricians agree that oral and parenteral antibiotics have equal efficacy. Co-amoxiclav is the antibiotic of choice for 41% of participants, while 9% prescribe amoxicillin. 80% of respondents prescribe ultrasound in all children with a confirmed urinary tract infection. 63% of respondents prescribe a cystography when abnormalities are revealed during ultrasound evaluation. A quarter of respondents recommend antibiotic prophylaxis for all children with any vesicoureteral reflux. The data among European countries are very heterogeneous. The three most recent urinary tract infection guidelines (the National Institute for Health and Care Excellence (NICE), the American Academy of Paediatrics and the Italian Society of Paediatric Nephrology) are not followed properly.ConclusionsManagement of febrile urinary tract infections remains controversial and heterogeneous in Europe. Simple, short, practical and easy-to-remember guidelines and educational strategies to ensure their implementation should be developed.

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Veshkurtseva, I. M., M. A. Akselrov, V. A. Emelyanova, S. N. Suprunets, A. V. Stolyar, S. N. Gordiychuk, K. A. Lebedeva, E. P. Ashikhmina, and A. L. Barinov. "Urinary tract infections in newborn children: microbial landscape and antibiotic resistance problems." Paediatric Surgery. Ukraine, no. 3(72) (September 29, 2021): 56–62. http://dx.doi.org/10.15574/ps.2021.72.56.

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Urinary tract infection is one of the most common bacterial infections in children, which in 30% of cases may be the first manifestation of the presence of congenital malformations of the urinary tract and urodynamic disorders in a child. Late diagnosis, initiation of therapy, and the choice of an inadequate antimicrobial drug increase the risks of disease progression, development of nephrosclerosis and patient disability. Purpose – to study the microbial landscape in urinary tract infections, its antibiotic resistance in newborns with anomalies in the development of the urinary system. Materials and methods. The results of microbiological examination of urine in newborns with urinary tract infections against the background of anomalies in the development of the urinary tract, which are being treated in intensive care units and neonatal pathology in the period 2016–2020, have been analyzed. Results. The main causative agents of urinary tract infections in newborns with anomalies of the urinary system are Enterobacterales (63.4%), 13.8% are producers of extended spectrum beta-lactamases. Cefoperazone/sulbactam, amikacin, meropenem and nitrofurantoin were most active against Escherichia coli. In relation to other representatives of the order Enterobacterales, only amikacin was highly active. The strains of Enterococcus spp., Detected in 20%, were resistant to reserve vancomycin in every fourth case. Representatives of non-fermenting gram-negative bacteria were found in 6.4% of cases, resistance to the main titrated antibiotics ranged from 44.4% to 100%. Conclusions. The main causative agents of urinary tract infections in newborns with anomalies of the urinary system are representatives of the order Enterobacterales, Enterococcus spp. and non-fermenting gram-negative bacteria, which were characterized by high resistance, including to reserve antibiotics. The high indices of resistance of the isolated microflora make it difficult to choose an effective antibacterial therapy in this category of patients and in most cases requires combined antibiotic therapy. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Urinary tract infection, newborn babies, urinary tract abnormalities, antibiotic resistance.

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Kawalec, Anna, and Danuta Zwolińska. "Emerging Role of Microbiome in the Prevention of Urinary Tract Infections in Children." International Journal of Molecular Sciences 23, no. 2 (January 14, 2022): 870. http://dx.doi.org/10.3390/ijms23020870.

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The microbiome of the urinary tract plays a significant role in maintaining health through the impact on bladder homeostasis. Urobiome is of great importance in maintaining the urothelial integrity and preventing urinary tract infection (UTI), as well as promoting local immune function. Dysbiosis in this area has been linked to an increased risk of UTIs, nephrolithiasis, and dysfunction of the lower urinary tract. However, the number of studies in the pediatric population is limited, thus the characteristic of the urobiome in children, its role in a child’s health, and pediatric urologic diseases are not completely understood. This review aims to characterize the healthy urobiome in children, the role of dysbiosis in urinary tract infection, and to summarize the strategies to modification and reshape disease-prone microbiomes in pediatric patients with recurrent urinary tract infections.

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Pînzaru, Anca Daniela, Raluca Mihai, Octavia Burcea, and Simona Claudia Cambrea. "Urinary tract infection in Children Hospitalized at Constanta Clinical Infectious Diseases Hospital." ARS Medica Tomitana 23, no. 4 (November 27, 2017): 175–79. http://dx.doi.org/10.1515/arsm-2017-0032.

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AbstractIntroduction: In pediatrics, the urinary tract infection is one of the most frequent bacterial infection, representing an important health problem due to its high incidence, wide etiology, asymptomatic evolution, and multiple and sever complications, relapses and sequelae.” Material and Method: We evaluated 45 children, aged between 6 months and 16 years, diagnosed and treated for urinary tract infection at the Clinical Infectious Diseases Hospital, of Constanta County, in a period of 3 years and 6 months. Results: During studied period, between January 2014 and June 2017 from a total of 9343 patients admitted to the Constanta Clinical Infectious Diseases Hospital, we selected 45 children (4.81‰) diagnosed with urinary tract infection. The average age of children with urinary tract infections was 5 years and 5 months. The gender distribution revealed a 2:1 balance in girl’s favor. The most affected group of age was 1-3 years. Fever was the dominating symptom. Urine cultures were positive for 37 cases, meanwhile for eight cases had been negative. The predominant germs are E. coli for female and for male Proteus. We noticed that for E. coli the highest sensitivity is preserved to Ertapenem -15 cases, followed by Ceftriaxone and Ciprofloxacin -10 cases each, and Gentamycin -9 cases. Conclusions: Pediatric urinary tract infection should be considered in every patient under 3 years with unexplained fever.

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Raza, Marium, Nighat Jabeen, Maryam Najam, Rizwana Tareen, Ayesha Intekhab, Qamar Uz Zaman Shahzad, and Muhammad Hamza. "Determine the Mean Levels of Vitamin D in Children with First Episode of Urinary Tract Infection." Pakistan Journal of Medical and Health Sciences 16, no. 9 (September 30, 2022): 733–35. http://dx.doi.org/10.53350/pjmhs22169733.

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Urinary tract infections (UTI) have a prevalence of 1% in boys and about 1-3% in girls. It is more common in boys under 1 year of age after which the incidence is higher in girls. Vitamin D is a fat-soluble vitamin that is synthesized in the skin epithelial cells and also obtained from diet. It has an important role in bone formation and deficiency of vitamin D leads to rickets in children. Objective: To determine the mean levels of vitamin D in children with first episode of urinary tract infection. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Study was conducted at Department of pediatrics, Fauji Foundation Hospital Rawalpindi from 16th Nov, 2021 to 16th May, 2022. Materials and Methods: 50 patients fulfilling the criteria for first episode of urinary tract infection included. All patients age, gender, height and weight were noted. Samples were inoculated on culture media and were examined at 24-48hrs for colony counts and bacterial identification. All patients who were tested positive for urinary tract infection had their serum Vitamin D 25(OH) D3 levels done, a deficiency was defined as values of less than 25ng/ml. Data was entered and analysed in SPSS version 22.0 Results: Mean age (6.70+3.9) with ranges from 02 to 12 years and Mean height (cm) and weight (kg) were (121.76+31.58), (25.64+12.36) respectively. There were 12 (24.0) male and 38 (76.0) female patients who were included in the study according to the inclusion criteria. Mean vitamin-D levels in children with first episode of urinary tract infection in the study was (23.46+1.68). Mean vitamin-D levels in children with first episode of urinary tract infection in children ages 02-06 years was (23.36+1.36), whereas mean vitamin-D levels in children ages 7 – 12 years was (23.54+1.91), Mean vitamin-D levels in among male and female children with first episode of urinary tract infection was (22.83+1.26) ( 23.66+1.76) which was statistically not significant (p-value 0.139). Mean vitamin-D levels in children with first episode of urinary tract infection in children have height between 101 – 175 cm, was (23.50+1.18). Mean vitamin-D levels in children with first episode of urinary tract infection in children having weight between 21 – 50 kg was (23.63+1.88). Conclusion: The study concluded that average vitamin D deficiency was substantial among children with urinary tract infection. Keywords: Urinary tract infections. Vitamin D levels, E coli

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Njaanake, Kariuki H., Job Omondi, Irene Mwangi, Walter G. Jaoko, and Omu Anzala. "Urinary interleukins (IL)-6 and IL-10 in schoolchildren from an area with low prevalence of Schistosoma haematobium infections in coastal Kenya." PLOS Global Public Health 3, no. 4 (April 5, 2023): e0001726. http://dx.doi.org/10.1371/journal.pgph.0001726.

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Urinary cytokines are gaining traction as tools for assessing morbidity in infectious and non-infectious inflammatory diseases of the urogenital tract. However, little is known about the potential of these cytokines in assessing morbidity due to S. haematobium infections. Factors that may influence the urinary cytokine levels as morbidity markers also remain unknown. Therefore the objective of the present study was to assess how urinary interleukins (IL-) 6 and 10 are associated with gender, age, S. haematobium infections, haematuria and urinary tract pathology and; 2) to assess the effects of urine storage temperatures on the cytokines. This was a cross-sectional study in 2018 involving 245 children aged 5–12 years from a S. haematobium endemic area of coastal Kenya. The children were examined for S. haematobium infections, urinary tract morbidity, haematuria and urinary cytokines (IL-6 and IL-10). Urine specimens were also stored at –20°C, 4°C or 25°C for 14 days before being assayed for IL6 and IL-10 using ELISA. The overall prevalence of S. haematobium infections, urinary tract pathology, haematuria, urinary IL-6 and urinary IL-10 were 36.3%, 35.8%, 14.8%, 59.4% and 80.5%, respectively. There were significant associations between prevalence of urinary IL-6, but not IL-10, and age, S. haematobium infection and haematuria (p = 0.045, 0.011 and 0.005, respectively) but not sex or ultrasound-detectable pathology. There were significant differences in IL-6 and IL-10 levels between urine specimens stored at –20°C and those stored at 4°C (p<0.001) and, between those stored at 4°C and those stored at 25°C (p<0.001). Urinary IL-6, but not IL-10, was associated with children’s age, S. haematobium infections and haematuria. However, both urinary IL-6 and IL-10 were not associated with urinary tract morbidity. Both IL-6 and IL-10 were sensitive to urine storage temperatures.

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Wachnicka-Bąk, Anna, Agata Będzichowska, Katarzyna Jobs, and Bolesław Kalicki. "An analysis of urinary tract infections in children up to 24 months of age: a 7-year single-centre follow-up." Pediatria i Medycyna Rodzinna 16, no. 4 (December 31, 2020): 377–81. http://dx.doi.org/10.15557/pimr.2020.0068.

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Introduction: Urinary tract infections are the second most common type of bacterial infection in children. Atypical infections may be associated with a higher future risk of chronic kidney disease. The current range of diagnostic tests in children with a history of urinary tract infections is still a subject of discussions. Aim of the study: We attempted to determine the indications for renal scintigraphy and develop a nephrological care model for children aged ≤24 months based on the analysis of urinary tract infections in this group of patients. Materials and methods: We included 61 children aged ≤24 months [42 (68%) girls and 19 (32%) boys], hospitalised in the Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine in Warsaw from 2008 to 2015 due to their first episode of urinary tract infection, in our retrospective analysis. Depending on the result of DMSA static renal scintigraphy performed 6 months after completed treatment of urinary tract infection, patients were classified into 3 groups: normal scintigraphy (group I), irregular tracer uptake indicating a suspicion of post-inflammatory renal pole lesions (group II), and signs of hypodysplasia (group III). The following variables were compared: age at first infection, gender, fever, inflammatory markers, aetiology, ultrasonographic findings, and the results of voiding cystourethrography for vesicoureteral reflux. Results: The median age at the time of first infection was 5.5 months in group I, 7 months in group II, and 7.5 months in group III. Febrile urinary infection was reported in 6/21 patients in group I, 4/19 patients in group II, and 6/21 patients in group III. Increased C-reactive protein was observed in 7/21 patients in group I, 6/19 patients in group II, and 6/21 patients in group III. Recurrent infections were reported for 5/21 children in group I, 8/19 in group II, and 12/21 children in group III. Atypical aetiology of urinary infection was reported for 3/21 patients in group I, 2/19 in group II, and 2/21 in group III. Abnormal ultrasonographic findings were observed in 4/21 patients in group I, 1/19 patients in group II, and 4/21 patients in group III. Vesicoureteral reflux in voiding cystourethrography was reported in 5/21 patients in group I, 8/19 patients in group II, and 10/21 patients in group III. The analysis of all the investigated parameters showed no statistically significant differences between the groups. Conclusions: Renal scintigraphy should be performed in the youngest children with a history of urinary tract infection as it was not possible to identify patients with post-inflammatory renal scarring secondary to urinary tract infection based on the course of infection, its aetiology, ultrasound findings and the presence of vesicoureteral reflux. Ultrasonography was not sensitive enough to diagnose renal hypodysplasia in our group of children.

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Johnson, Candice E., Baz P. DeBaz, Paul A. Shurin, and Rose DeBartolomeo. "Renal Ultrasound Evaluation of Urinary Tract Infections in Children." Pediatrics 78, no. 5 (November 1, 1986): 871–78. http://dx.doi.org/10.1542/peds.78.5.871.

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Ultrasonography of the kidney may replace the intravenous pyelogram as the study of choice in identifying treatable abnormalities in children with urinary tract infection. In a series of 64 consecutive children with urinary tract infection in whom an intravenous pyelogram, renal ultrasound, and voiding cystogram were performed, only one treatable abnormality (calyceal dilation) was identified by intravenous pyelogram, and it was not detected by ultrasound. Eleven children showed vesicoureteral reflux on the cystogram. In an additional 43 children in whom intravenous pyelogram was done only if the ultrasound or cystogram were abnormal, there were five abnormal cystograms. Four treatable abnormalities were identified by ultrasound, and three were confirmed by the intravenous pyelogram. Ultrasound should replace the intravenous pyelogram in children with a normal cystogram because of its accuracy, safety, and high patient acceptance. We have also documented a significant volume increase with acute infection in one or both kidney(s) of those children having upper urinary tract infection. Fifteen of 18 children with upper urinary tract infection had volume increases of 30% on more in at least one kidney; whereas only four of 21 children with lower urinary tract infection had increases of greater than 30% (P < .005). Ultrasound volume measurements provide a new, noninvasive method for identifying the probable site of urinary tract infection.

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Shortliffe, Linda M. Dairiki. "THE MANAGEMENT OF URINARY TRACT INFECTIONS IN CHILDREN WITHOUT URINARY TRACT ABNORMALITIES." Urologic Clinics of North America 22, no. 1 (February 1995): 67–73. http://dx.doi.org/10.1016/s0094-0143(21)01017-x.

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Feld, Leonard G., Saul P. Greenfield, and Pearay L. Ogra. "Urinary Tract Infections in Infants and Children." Pediatrics In Review 11, no. 3 (September 1, 1989): 71–77. http://dx.doi.org/10.1542/pir.11.3.71.

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CASE HISTORY AND OFFICE DIAGNOSIS A 7-month-old uncircumcised male infant had vomiting, diarrhea, and low grade fever (38.4°C) 2 days before coming to the pediatrician's office. One day before seeing the baby, the physician prescribed Pedialyte and acetaminophen elixir. The child appeared active to the pediatrician. Mucous membranes were slightly dry and tears were present. His blood pressure was 98/62 mm Hg, pulse rate 92 beats per minute, and temperature 38°C. Laboratory evaluation included an analysis and culture of catheterized urine sample: specific gravity, 1.025; pH, 6.0; protein, trace; blood, negative; sugar and ketones, negative; sediment—0 to 1 red blood cells per high-power field; 6 to 8 white blood cells per high-power-field and no bacteria. Based on the differential diagnosis of viral gastroenteritis vs urinary tract infection, the patient was sent home with a prescription for Pedialyte and acetaminophen and the parents were told to call the office in 24 hours for test results. The urine culture was positive for greater than 100 000 colonies per milliliter of a single organism which was later identified as Escherichia coli and sensitive to all antibiotics. The child was started on a regimen of amoxicillin. Two weeks later, a repeat urine culture was negative for bacteria.

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Feld, L. G., S. P. Greenfield, and P. L. Ogra. "Urinary Tract Infections in Infants and Children." Pediatrics in Review 11, no. 3 (September 1, 1989): 71–77. http://dx.doi.org/10.1542/pir.11-3-71.

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Schellack, Natalie, Cahlia Naested, Nicolene Van der Sandt, and Neelaveni Padayachee. "Management of Urinary Tract Infections in Children." South African Family Practice 59, no. 2 (November 7, 2017): 16–20. http://dx.doi.org/10.4102/safp.v59i6.4772.

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Urinary Tract Infections (UTIs) are a common occurrence in paediatrics. UTIs present in children as fever, anorexia, vomiting, lethargy and dysuria. Approximately 80% of the time, Escherichia coli is the causative bacteria in paediatrics, however, fungal UTI caused by Candida species can occur in premature infants. With an estimated 150 million UTIs occurring worldwide annually, this paper aims to establish the ideal management of urinary tract infections in paediatrics. Clinical signs and symptoms of UTI in paediatrics are dependent on age of the child. Neonates (0–27 days old) present with sepsis, vomiting, fever, and prolonged jaundice, while school aged children present with symptoms similar to adults such as dysuria and urgency. Diagnosis of a UTI can be done by using a urine dipstick or using the midstream clean catch method in toilet trained children, and using the transurethral catheterisation or suprapubic aspiration method for infants and young children. In the wake of antibiotic resistance, choosing the best anti-microbial agent for treatment is imperative. Whilst asymptomatic bacteriuria does not require antibiotic treatment, amoxicillin and clavulanic acid combination, cephalexin, cefixime and cefpodoxime are the preferred oral antibiotics, provided there are no known allergies. Ceftriaxone, ampicillin, cefotaxime and gentamycin are the recommended parenteral antibiotics, provided age, allergic status and renal function are considered prior to use. Careful consideration needs to be given before using prophylaxis in UTIs and should be reserved for extreme cases.

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Edmonson;, M. B., B. Jakobsson, E. Esbjorner, and S. Hansson. "First Urinary Tract Infections in Swedish Children." PEDIATRICS 106, no. 3 (September 1, 2000): 620–21. http://dx.doi.org/10.1542/peds.106.3.620.

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Hamburger, Ellen Kravis. "Urinary tract infections in infants and children." Postgraduate Medicine 80, no. 6 (November 1986): 235–41. http://dx.doi.org/10.1080/00325481.1986.11699603.

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Quigley, Raymond. "Diagnosis of urinary tract infections in children." Current Opinion in Pediatrics 21, no. 2 (April 2009): 194–98. http://dx.doi.org/10.1097/mop.0b013e328326f702.

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Doern, Christopher D., and Susan E. Richardson. "Diagnosis of Urinary Tract Infections in Children." Journal of Clinical Microbiology 54, no. 9 (April 6, 2016): 2233–42. http://dx.doi.org/10.1128/jcm.00189-16.

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Urinary tract infections (UTIs) are a common occurrence in children. The management and laboratory diagnosis of these infections pose unique challenges that are not encountered in adults. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing, require special consideration in children and will be discussed in detail in the following review.

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Sherbotie, Joseph R., and David Cornfeld. "Management of Urinary Tract Infections in Children." Medical Clinics of North America 75, no. 2 (March 1991): 327–38. http://dx.doi.org/10.1016/s0025-7125(16)30457-6.

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