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Symptomatic urinary tract infections following voiding cystourethrography
Marianna Rachmiel1, Mordechay Aladjem, Ruth Starinsky
1Department of Pediatrics, Assaf Harofeh Medical Center, 70300 Zerifin, Israel.
Pediatric Nephrology (Berlin, Germany)
|July 28, 2005
Summary
Urinary tract infections (UTIs) after voiding cystourethrography (VCUG) are uncommon in children receiving antibiotics. However, vesicoureteral reflux (VUR) increases UTI risk, particularly Pseudomonas infections.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Diagnostic Imaging
Background:
- Voiding cystourethrography (VCUG) is a common diagnostic tool in pediatric urology.
- Urinary tract infections (UTIs) are a potential complication following VCUG.
- Prophylactic antibiotics are often administered to mitigate UTI risk.
Purpose of the Study:
- To determine the incidence of symptomatic UTIs after VCUG in children receiving prophylactic antibiotics.
- To identify risk factors associated with developing UTIs post-VCUG.
Main Methods:
- Retrospective review of medical records for 421 pediatric patients who underwent VCUG.
- Analysis of UTI symptoms, culture results, and VCUG findings within 7-10 days post-procedure.
- Multivariate logistic regression to assess risk factors for UTI development.
Main Results:
- A low overall incidence of symptomatic UTI (1.7%) was observed post-VCUG.
- Vesicoureteral reflux (VUR) and its severity were significant risk factors for developing UTI (OR 2.52 and 2.32).
- A notable proportion of UTIs were caused by Pseudomonas aeruginosa, especially in cases with moderate to severe VUR.
Conclusions:
- Prophylactic antibiotics effectively reduce the incidence of UTIs following VCUG in children.
- Children with VUR, particularly moderate to severe cases, are at higher risk for UTIs post-VCUG.
- Empirical treatment for Pseudomonas aeruginosa is recommended for children with UTI symptoms after VCUG pending culture results.