Childhood recurrent urinary tract infection in southern Thailand

Area of Science:

• Pediatrics
• Infectious Diseases
• Urology

Background:

• Recurrent urinary tract infections (UTIs) pose a significant health challenge in pediatric populations due to their high incidence.
• Understanding the prevalence and risk factors is crucial for effective management and prevention strategies.

Purpose of the Study:

• To determine the prevalence of recurrent UTIs in Thai children.
• To identify significant risk factors associated with recurrent UTIs in this demographic.

Main Methods:

• Retrospective review of medical records for children under 15 diagnosed with UTI at Songklanagarind Hospital.
• Follow-up of 307 children for at least one year to assess recurrence rates and identify associated factors.

Main Results:

• The recurrence rate for UTIs was approximately 18.2% (56 out of 307 children), with no significant difference between sexes.
• Genitourinary (GU) anomalies, especially vesicoureteral reflux (VUR), and age greater than 5 years were identified as independent risk factors.
• While Escherichia coli remained the primary pathogen, its prevalence decreased in recurrent UTIs, with a notable increase in Klebsiella pneumoniae and other organisms.

Conclusions:

• Approximately one-fifth of pediatric UTI cases experience recurrence, with similar rates observed in both males and females.
• Age over 5 years and underlying genitourinary anomalies, including VUR, are significant independent risk factors for recurrent UTIs in children.
• Changes in causative organisms, with a decrease in E. coli and an increase in K. pneumoniae and mixed flora, warrant consideration in treatment protocols for recurrent UTIs.