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Establishment and Characterization of UTI and CAUTI in a Mouse Model
Published on: June 23, 2015
Epidemiology and natural history of urinary tract infections in children
1Department of Pediatrics, Medical College of Pennsylvania, Philadelphia.
Insights
Urinary tract infections (UTIs) affect 0.3% to 1.2% of infants, with risk factors including age, sex, and lack of circumcision in boys. E. coli
Area of Science:
- Pediatrics
- Infectious Diseases
- Urology
Background:
- Urinary tract infections (UTIs) are common in infants, with varying incidence and risk factors based on age and sex.
- Boys are more susceptible in the first three months, while girls are more affected after the first year.
- Lack of circumcision is identified as a risk factor for UTIs in male infants.
Purpose of the Study:
- To review the incidence and risk factors associated with urinary tract infections in infants.
- To explore the microbiologic and host factors contributing to UTIs and pyelonephritis.
- To investigate determinants of renal scarring in pediatric UTIs.
Main Methods:
- Retrospective survey analysis of infant UTI incidence.
- Review of microbiologic factors, including E. coli virulence factors like P fimbriae.
- Examination of host factors, such as vesicoureteral reflux.
Main Results:
- Infant UTI incidence ranges from 0.3% to 1.2%, with sex-based differences observed.
- Recurrent UTIs are common and often asymptomatic.
- E. coli's P fimbriae mediate adherence, crucial for acute pyelonephritis; other factors influence invasiveness.
Conclusions:
- UTI incidence in infants is significant, influenced by age, sex, and circumcision status.
- Microbiologic and host factors play critical roles in UTI pathogenesis and severity.
- Further research is needed to fully understand factors leading to renal scarring.
Abstract:
Recent retrospective surveys have supported previous investigations in demonstrating the incidence of UTI during infancy; 0.3% to 1.2% of infants develop symptomatic UTI during the first year of life. Boys are more commonly infected during the first 3 months of life. After the first year, symptomatic UTI is much more frequent among girls. Similarly, asymptomatic bacteriuria is more frequently detected in boys than in girls during the first 12 months of life. Thereafter, the incidence decreases markedly in boys but increases in girls. Recent investigations indicate that lack of circumcision is a risk factor for UTI among male infants. Recurrent UTI is common and frequently asymptomatic. The most important microbiologic factor that is associated with E. coli causing acute pyelonephritis is adherence mediated by P fimbriae. Other factors, such as capsule, lipopolysaccharide, aerobactin production, and serum resistance, also determine the invasiveness of E. coli. Vesicoureteral reflux appears to be an important host factor predisposing to UTI. Microbiologic and host factors that are determinants of renal scarring are under investigation.
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