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[Bacteriology and serology of pyelonephritis in children (author's transl)]
Insights
This study reviewed bacterial causes of pyelonephritis in children under 7. E. coli was most common, but K pneumoniae predominated in newborns, with a correlation between serology and kidney damage.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Urology
Context:
- Pyelonephritis, a severe urinary tract infection, can cause renal damage, particularly in young children.
- Understanding the specific bacterial pathogens and their prevalence is crucial for effective treatment and management.
- This review analyzes microbiological data from a large cohort of children under seven years old.
Purpose:
- To review bacterial pathogenicity factors associated with urinary tract invasion and renal damage in pediatric pyelonephritis.
- To analyze microbiological findings from quantitative cultures in children under seven over a nine-year period.
- To evaluate the utility of serological testing (o-agglutination) in determining the site of infection and correlation with renal involvement.
Summary:
- A review of 14,181 quantitative cultures identified Escherichia coli as the most frequent pathogen (nearly 50%) in pediatric pyelonephritis.
- Klebsiella pneumoniae was notably prevalent in premature infants and newborns (20-30%), while Proteus and Pseudomonas species were more common in older children.
- Hospital-acquired urinary tract infection epidemics were not observed. A positive o-agglutination serological test showed a close correlation with renal involvement.
Impact:
- Highlights the etiological spectrum of pyelonephritis in young children, differentiating pathogen prevalence by age group.
- Suggests that serological testing can be a valuable tool in assessing renal involvement in pediatric pyelonephritis.
- Provides insights for targeted antimicrobial therapy and improved clinical management of pediatric urinary tract infections.
Abstract:
A short review is made on the bacterial pathogenicity factors related with urinary-tract invasion and renal damage in pyelonephritis. Microbiological findings obtained after a revision of 14,181 quantitative cultures carried our in the last nine years on children under 7 years old are discussed. "E. coli" is implicated in almost a half of positive cultures; "K pneumoniae" seems to be specially related with urinary infections of premature and newborn infants (20-30% of the bacterial positivities in both groups). "Proteus" and "Pseudomonas" have more etiological weight in older children. True hospital epidemics of urinary infections have been non observed. As serological test, the o-agglutination of homologous strain (technique of Karmierczac et al.) was used in order to determine the site of infection. A rather close correlation between positivity of serologic test and renal involvement is showed.