Related Experiment Video
Updated: Aug 22, 2026
Recurrent Escherichia coli Urinary Tract Infection Triggered by Gardnerella vaginalis Bladder Exposure in Mice
Published on: December 4, 2020
Recurrence risk in infants with urinary tract infections and a negative radiographic evaluation
Gennady Bratslavsky1, Paul J Feustel, Ahmet R Aslan
1Department of Surgery, Division of Urology, Albany Medical College, Albany, New York 12208, USA. bratslg@mail.amc.edu
Insights
Approximately 20% of infants experience recurrent urinary tract infections (UTIs) even after normal imaging. Risk factors like female gender and prior fevers showed a trend but were not statistically significant for UTI recurrence.
Area of Science:
- Pediatrics
- Urology
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are common in infants.
- Infants with normal initial radiological evaluations are often discharged from urological follow-up.
- The long-term outcomes and recurrence rates for these children are not well-established.
Purpose of the Study:
- To determine the rate of recurrent UTIs in infants with initially normal radiological findings.
- To identify potential risk factors associated with UTI recurrence in this specific pediatric population.
Main Methods:
- Retrospective chart review of infants under 6 months with a first UTI.
- Inclusion criteria: normal ultrasound and voiding cystourethrogram.
- Data collection via parental telephone questionnaire including UTI history, feeding, family history, and other medical issues.
- Statistical analysis using Chi-square test.
Main Results:
- 119 infants (45%) had normal ultrasound and voiding cystourethrogram after their first UTI.
- Recurrent UTIs were observed in 16 out of 84 children (19%) with a mean follow-up of 4.4 years.
- No statistically significant risk factors for recurrence were identified.
- A trend towards increased recurrence was noted in girls (p=0.077) and those with a history of undiagnosed fevers (p=0.082).
Conclusions:
- Nearly 20% of infants experience recurrent UTIs despite negative initial radiological evaluations.
- While not statistically significant, female gender and a history of recurrent febrile illnesses may indicate a higher risk.
- Daytime dryness and constipation were not predictive of recurrent UTIs in this cohort.
Purpose:
Infants with urinary tract infections (UTI) and no abnormality on radiological evaluation are usually discharged from urological followup but the natural history of these children is unknown. We evaluate the rate of and potential risk factors for UTI recurrence in this specific population.
Materials And Methods:
We reviewed retrospectively charts of children evaluated for first UTI before age 6 months between January 1996 and February 2001. Only patients with a normal ultrasound and voiding cystourethrogram were included in this study. A telephone questionnaire was administered to the parents, which inquired about the UTI, duration of breast-feeding, type of formula, family history of UTI, neurological problems, history of constipation or recurrent fevers, as well as social status. Chi-square test was performed for statistical analysis.
Results:
We identified 264 children with UTIs, of whom 119 (45%) had a negative ultrasound and voiding cystourethrogram. Followup was available on 68 girls (81%) and 16 boys (19%) of the 119 children (71%). Of the 84 children 16 (19%) had recurrent UTI. Mean followup was 4.4 years (range 1.9 to 7.0). No factors had a statistically significant correlation for UTI recurrence. The p value for gender and history of undiagnosed fevers was 0.077 and 0.082, respectively.
Conclusions:
About 20% of children will have recurrent UTIs despite negative radiological evaluation. Although not statistically significant, there was a trend for an increased risk in girls and those with recurrent febrile illnesses. History of daytime dryness and/or constipation was not predictive of recurrent UTIs in our series.
Related Concept Videos
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:28Urinary Tract Calculi V: Nursing Management
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:26Urinary Tract Infection I: Introduction
01:25Urinary Tract Infection II: Pathophysiology
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations