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Urologic diagnoses among infants hospitalized for urinary tract infection
Michael H Hsieh1, Ramiro J Madden-Fuentes, David R Roth
1Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA. mhhsieh@stanfordalumni.org
Insights
Over 14% of infants hospitalized for urinary tract infections (UTIs) have urologic anomalies. Common diagnoses include hydronephrosis and vesicoureteral reflux, necessitating screening for anatomical abnormalities.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Medical Diagnostics
Background:
- Urinary tract infections (UTIs) are common in infants.
- Urologic anomalies are a known risk factor for UTIs.
- The prevalence of urologic disease in infants hospitalized for UTI is not well-established.
Purpose of the Study:
- To determine the prevalence of urologic disease among infants hospitalized for UTIs.
- To identify common urologic anomalies in this population.
- To establish the need for screening in infants with UTI.
Main Methods:
- Retrospective analysis of infant hospitalization records for UTI over a 10-year period.
- Inclusion criteria: infants <400 days old hospitalized for UTI.
- Data collected: race, sex, urologic diagnosis (ICD-9 codes), UTI documentation and workup.
Main Results:
- 914 infants hospitalized with UTI; 258 had a urologic diagnosis.
- 130 infants (14.2%) had well-documented UTI.
- Common diagnoses: hydronephrosis (37.7%), vesicoureteral reflux (69.2%), obstructive uropathy (23.1%).
Conclusions:
- At least 14% of infants hospitalized for UTI have underlying urologic anomalies.
- Vesicoureteral reflux, obstructive uropathy, and hydronephrosis are frequent diagnoses.
- Infants hospitalized with UTI should be screened for anatomical abnormalities.
Objectives:
To determine the prevalence of urologic disease among infants hospitalized for urinary tract infections (UTIs) at our institution. The prevalence of urologic anomalies among infants (<400 days old) hospitalized for UTIs has not been previously reported.
Methods:
We retrospectively examined the records of all infants hospitalized for UTI at our institution, a free-standing children's hospital in the United States, for a 10-year period. Race, sex, and subsequent urologic diagnosis (using codes from the 9(th) edition of the International Classification of Diseases [ICD-9] were tabulated. Individual charts were reviewed to confirm documentation and workup of UTI.
Results:
We identified 914 infants hospitalized at our institution from January 1996 to December 2007, with an ICD-9-coded diagnosis of UTI. Of these 914 infants, 258 were subsequently given a urologic diagnosis. However, only 130 of these patients had well-documented UTI (14.2% of 914 children). Of this cohort, 55.4% were boys. The most common diagnoses were hydronephrosis (37.7%), vesicoureteral reflux (69.2%), and obstructive uropathy (23.1%).
Conclusions:
Our data have indicated that > or =14% of all infants hospitalized for UTI have urologic anomalies. Vesicoureteral reflux, obstructive uropathy, and hydronephrosis are common diagnoses. We therefore conclude that infants admitted with a diagnosis of UTI should undergo screening for anatomic abnormalities.
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