Clinical and laboratory features of urinary tract infections in young infants (original) (raw)
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Urinary tract infection in the newborn and the infant: state of the art
The Journal of Maternal-Fetal & Neonatal Medicine, 2010
Urinary tract infection is one of the most common cause of infection in newborns. Obtaining a urinary tract infections (UTIs) diagnosis just on the basis of the clinical findings is frequently difficult, however, being the pediatrician's goal to reduce the risk of renal scarring, a prompt diagnosis and treatment is of extreme importance. The key instrument for the diagnosis of UTIs is represented today by urine culture. However, in reality, the caregivers and investigators are increasingly demanding fast and cheap methods for a rapid and effective diagnosis.
First urinary tract infection in neonates, infants and young children: a comparative study
Pediatric Nephrology, 2006
In an attempt to evaluate first urinary tract infection (UTI) in neonates and infants, we estimated retrospectively in 296 patients (62 neonates and 234 infants) clinical and laboratory findings, occurrence of vesicoureteral reflux (VUR), urinary tract abnormalities and pyelonephritis. First UTI occurred more often in male than female neonates, whereas male and female infants/young children were affected at an equal rate. The pathogens isolated in urine cultures of neonates and infants did not statistically significantly differ (P>0.05); Escherichia coli predominated. Gram-negative bacteria other than E. coli affected boys more often than girls (P=0.0022). Fever was the most frequent symptom. Neonates had lower-grade fever of shorter duration than infants (P<0.05). The incidence of reflux and urinary tract abnormalities did not differ between neonates and infants, male and female neonates and infants (P>0.05). Pyelonephritis affected neonates and infants at an equal rate; it was more prevalent among female patients (P=0.038) and patients with VUR or urinary tract abnormalities other than VUR (P<0.0001). Neonates with reflux were more often affected by Gram-negative bacteria other than E. coli than were neonates without reflux (P=0.0008).
Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger
Pediatrics, 2018
Reports of the test accuracy of the urinalysis for diagnosing urinary tract infections (UTIs) in young febrile infants have been variable. We evaluated the test characteristics of the urinalysis for diagnosing UTIs, with and without associated bacteremia, in young febrile infants. We performed a planned secondary analysis of data from a prospective study of febrile infants ≤60 days old at 26 emergency departments in the Pediatric Emergency Care Applied Research Network. We evaluated the test characteristics of the urinalysis for diagnosing UTIs, with and without associated bacteremia, by using 2 definitions of UTI: growth of ≥50 000 or ≥10 000 colony-forming units (CFUs) per mL of a uropathogen. We defined a positive urinalysis by the presence of any leukocyte esterase, nitrite, or pyuria (>5 white blood cells per high-power field). Of 4147 infants analyzed, 289 (7.0%) had UTIs with colony counts ≥50 000 CFUs/mL, including 27 (9.3%) with bacteremia. For these UTIs, a positive uri...
Pediatric Infectious Disease, 2019
Objectives: To study the clinical characteristics and etiological agents of urinary tract infection (UTI) in children of 2 months to 12 years, and to find the prevalence of vesicoureteric reflux (VUR) in children with UTI. Materials and methods: This prospective study was conducted among 47 children with culture-positive UTI in children between 2 months to 12 years. All children attending the pediatric outpatient department (OPD) of Government Medical College Hospital, Kannur, Kerala, India, were enrolled. Clinical and bacteriological profile of all cases were evaluated and ultrasonogram (USG) abdomen/micturating cystourethrogram (MCU) were done for these patients to find the predisposing factors associated with recurrent infections like VUR and posterior urethral valve. Results: A total of 47 children were enrolled, of which 25 (53.19%) children were below 1 year of age. Male to female ratio was 2.1:1. The most common symptom was fever, and Escherichia coli (65.9%) was the most common organism isolated. Within the cohort, 23.40% of children had recurrent UTI and 19.14% showed VUR. Conclusion: Urinary tract infection is a very common infection in infants and children. It is equally important that we treat the child with antibiotics and investigate for any underlying causes such as VUR or obstructive uropathy.
Factors Associated With Bacteremia in Young Infants With Urinary Tract Infection
The Pediatric Infectious Disease Journal
Background: Urinary tract infection (UTI) is the most frequent severe bacterial infection in infants. Up to 31% of infants with UTI have bacteremia. Methods: We retrospectively identified all infants aged 0-2 months who were managed in our hospital with UTI during a 1-year period. Those with bacteremia were compared with those without bacteremia, according to the following variables: ethnicity, age, gender, white blood cell and polymorphonuclear counts, C-reactive protein, urinalysis and blood creatinine values as related to age-appropriate norms, imaging and outcome. Results: We identified 81 infants with 82 episodes of UTI. Most occurred in males (72.8%) and 35 (42.7%) were in infants of non-Jewish origin. In 14/81 (17.3%) of episodes, Escherichia coli was cultured from blood. In multivariate analysis, increased blood creatinine levels (P = 0.004) and non-Jewish origin (P = 0.006) were associated with bacteremia. Time to defervescence was significantly longer in bacteremic versus ...
Journal of Academy of Medical Sciences, 2012
Morbidity associated with pyelonephritis is characterized by systemic symptoms, such as fever, abdominal pain, vomiting, and dehydration. Bacteremia and clinical sepsis may occur. Children with pyelonephritis also may have cystitis. Long-term complications of pyelonephritis are hypertension and impaired end-stage renal disease. The voiding symptoms of cystitis are usually transient, clearing within 24-48 h of effective treatment. Long-term complications of UTI are caused by renal damage secondary to pyelonephritis. [4] UTI are almost always ascending in origin and caused by bacteria in the periurethral flora and the distal urethra. These bacteria inhabit the distal gastrointestinal tract and colonize the perineal area. Escherichia coli usually cause a child's first infection (were responsible for more than 90% of cases of acute pyelonephritis in infants and children), but other gram-negative bacilli and enterococci may also cause infection. More rarely, the urinary tract may be colonized during systemic bacteremia (sepsis), this usually happens in infancy. [5] Negative microscopic findings for bacteria do not rule out a UTI, nor do negative results of dipstick testing for nitrite and leukocyte esterase. [6] InTRoDuCTIon UTI is defined as significant bacteriuria irrespective of the site of infection in the urinary tract. [1] The exact rate of urinary tract infections (UTIs) in newborns is not known, but studies have found that from about 1 in 1000 to 1 in 100 in full-term infants, and up to 1 in 10 premature infants, will have a UTI during the first month of life. [2] Most newborns and young infants present with symptoms of UTI and not asymptomatic bacteriuria. The higher incidence of UTI among male infants persists for the first 3-4 months of life, but thereafter the incidence and prevalence of UTI are considerably higher in females compared with males.