Bacteremic urinary tract infection in children

Area of Science:

• Pediatrics
• Infectious Diseases
• Urology

Background:

• Urinary tract infections (UTIs) are common in children.
• Bacteremic UTIs, where bacteria are present in the bloodstream, require careful assessment.
• Distinguishing bacteremic from non-bacteremic UTIs based on clinical presentation is crucial for appropriate management.

Purpose of the Study:

• To evaluate the clinical characteristics of children diagnosed with bacteremic urinary tract infections (UTIs).
• To compare the clinical findings, laboratory results, and imaging data of children with bacteremic UTI versus those with non-bacteremic UTI.

Main Methods:

• A retrospective analysis of clinical data from Finnish children with bacteremic UTI (n=134) between 1985 and 1994.
• Comparison of symptoms, laboratory findings (serum C-reactive protein), and imaging results with age- and sex-matched controls with blood culture-negative UTI.
• Assessment of urinary tract abnormalities, including obstruction and vesicoureteral reflux (VUR).

Main Results:

• No significant differences in most clinical symptoms were observed between bacteremic and non-bacteremic UTI groups.
• Bacteremic children showed more frequent feeding problems and, if older than 12 months, abdominal pain and vomiting.
• Higher serum C-reactive protein levels and longer fever duration post-treatment were noted in bacteremic patients.
• Urinary tract abnormalities, specifically obstruction and high-grade VUR, were significantly more prevalent in bacteremic UTI cases, especially those not caused by E. coli.

Conclusions:

• Clinical symptoms are not reliable indicators for differentiating bacteremic from non-bacteremic UTIs in children.
• The outcomes of bacteremic and non-bacteremic UTIs were comparable.
• Bacteremic UTIs, particularly those caused by non-E. coli pathogens, are more frequently associated with underlying anatomical or functional urinary tract abnormalities.