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Predictors Of Non-Escherichia Coli Urinary Tract Infection
Nader Shaikh1, Ellen R Wald, Ron Keren
1From the *Division of General Academic Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania; †Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; ‡Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; §Department of Biostatistics, University of North Carolina at Chapel Hill, Collaborative Studies Coordinating Center, Chapel Hill, North Carolina; and ¶National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
Insights
Certain children are more likely to develop non-Escherichia coli urinary tract infections (UTIs). Circumcised males, Hispanic children, those without fever, and with high-grade vesicoureteral reflux are at increased risk for these UTIs.
Area of Science:
- Pediatrics
- Infectious Diseases
- Urology
Background:
- Urinary tract infections (UTIs) are common in children.
- Escherichia coli is the most frequent causative agent of pediatric UTIs.
- Identifying risk factors for non-E. coli UTIs is crucial for targeted treatment.
Purpose of the Study:
- To identify specific pediatric patient characteristics associated with non-Escherichia coli UTIs.
- To inform clinical decision-making regarding antimicrobial selection for pediatric UTIs.
Main Methods:
- Retrospective analysis of 769 children diagnosed with UTI.
- Comparison of demographic and clinical factors between E. coli UTI and non-E. coli UTI groups.
Main Results:
- Circumcised males were more prone to non-E. coli UTIs.
- Hispanic ethnicity was associated with a higher likelihood of non-E. coli UTIs.
- Absence of fever and grades 3-4 vesicoureteral reflux were significant predictors of non-E. coli UTIs.
Conclusions:
- Specific subgroups of children, including circumcised males, Hispanic children, afebrile children, and those with high-grade VUR, are at higher risk for non-E. coli UTIs.
- These findings can assist clinicians in selecting appropriate empirical antimicrobial therapy based on patient risk factors.
Abstract:
We aimed to determine which children are prone to non-Escherichia coli urinary tract infection (UTIs). We included 769 children with UTI. We found that circumcised males, Hispanic children, children without fever and children with grades 3 and 4 vesicoureteral reflux were more likely to have a UTI caused by organisms other than E. coli. This information may guide clinicians in their choice of antimicrobial therapy.
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