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[Urinary tract infection in children: clinical analysis and investigation]
Insights
Urinary tract infections in children can cause kidney damage. Early diagnosis and treatment, especially for severe vesicoureteral reflux, are crucial for preventing long-term renal disease.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Urology
Context:
- Urinary tract infections (UTIs) are common in children.
- UTIs can lead to severe and progressive renal disease.
- This study analyzed suspected UTI cases in a Taiwanese hospital from 1983-1987.
Purpose:
- To investigate the characteristics of childhood UTIs.
- To identify common pathogens and antibiotic sensitivities.
- To evaluate the prevalence of urinary tract abnormalities and their management outcomes.
Summary:
- 24 pediatric UTI cases met diagnostic criteria.
- Escherichia coli was the most common pathogen.
- Urinary abnormalities, including vesicoureteral reflux, were found in 37.5% of cases.
- High antibiotic sensitivity to gentamicin and amikacin was observed.
- Surgery for severe reflux yielded positive outcomes, though complications occurred.
Impact:
- Highlights the importance of identifying and managing urinary abnormalities in children with UTIs.
- Provides data on common UTI pathogens and effective antibiotic treatments in a pediatric population.
- Informs clinical practice regarding the long-term renal health of children with UTIs.
Abstract:
The urinary tract is a common site for bacterial infection in childhood. The most important aspect of urinary tract infection in childhood is that it can lead to severe and progressive renal disease. From March 1983 to March 1987, 63 cases of suspected urinary tract infection were collected in Taichung VGH. Among them only 24 cases reached our diagnostic criteria. Eight cases were within 2 years old, which all are male. Sixteen cases were beyond 2 years old, which the ratio of male to female is 1:1. Eighteen cases presented pyuria. Ten cases had recurrent infections, among which eight cases had urinary abnormalities. The most common pathogenic organism was E. coli (44%), then Proteus (24%), Klebsiella (16%), Pseudomonas (12%). The antibiotics sensitivity test revealed 95.7% were sensitive to gentamicin and amikacin, 81% to cephalothin, 56. 5% to sulfamethoxazole-trimethoprim. Imaging studies revealed nine cases (37.5%) with urinary tract abnormalities, including vesicoureteral refluxes 6 cases, right multicystic kidney with left vesicoureteral reflux 1 case, horse-shoe kidney 1 case, atonic bladder 1 case. The ratio of male to female is 2:1. All seven cases of severe vesicoureteral refluxes received surgery. One case developed post-operative ureteral stricture. One case occurred unilateral chronic renal parenchymal disease one year later. Others were free of reflux and reinfection of urinary tract.