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Long-term outcomes of urinary tract infection (UTI) in Childhood (LUCI): protocol for an electronic record-linked
Fiona V Lugg-Widger1, Lianna Angel1, Rebecca Cannings-John1
1Centre for Trials Research, Cardiff University, Cardiff, UK.
Insights
The LUCI study investigates childhood urinary tract infections (UTIs) and their long-term effects. It compares outcomes from routine versus systematic urine sampling to understand UTI complications in children.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Health Services Research
Background:
- Childhood urinary tract infection (UTI) diagnosis and treatment are crucial for outcomes, yet long-term risks remain unclear.
- Non-specific symptoms and diagnostic challenges in children complicate UTI identification.
- Current urine sampling practices in primary care for pediatric UTI are not standardized.
Purpose of the Study:
- To assess short, medium, and long-term outcomes of childhood UTI.
- To compare outcomes associated with routine versus systematic urine sampling practices.
- To clarify the risk of long-term complications following pediatric UTI.
Main Methods:
- Establish two linked datasets using routinely collected data and prospective studies (DUTY, EURICA).
- Utilize the Secure Anonymised Information Linkage (SAIL) Databank and NHS Digital for data linkage.
- Compare outcomes such as renal scarring, hypertension, and end-stage renal failure in children with and without microbiologically confirmed UTI (mcUTI).
Main Results:
- This section is to be filled once the study is completed and results are available.
Conclusions:
- This section is to be filled once the study is completed and conclusions are drawn.
Introduction:
Current guidelines advise the prompt diagnosis and treatment of urinary tract infection (UTI) in children to improve both short and longer term outcomes. However, the risk of long-term complications following childhood UTI is unclear.UTI is relatively common but difficult to diagnose in children as symptoms are non-specific. Diagnosis requires a urine sample, but sampling is difficult and infrequent, and it is not clear if sampling should be given greater priority in primary care. The LUCI study will assess the short, medium and longer term outcomes of childhood UTI associated with routine and systematic sampling practices.
Methods And Analysis:
Two data sets will be established. The first will consist of routinely collected data (hospital, general practice (GP), microbiology) from children born and resident in Wales, linked via the Secure Anonymised Information Linkage (SAIL) Databank (an 'e-cohort'). Urine sampling in this data set reflects normal practice 'routine sampling'. Outcomes (including renal scarring, hypertension, end-stage renal failure, hospital admissions, GP consultations, antibiotic prescriptions) for children with at least one UTI confirmed with microbiological culture (mcUTI) or no mcUTI before the age of 5 will be compared.The second will combine data from two prospective observational studies ('DUTY' and 'EURICA') employing systematic urine sampling for children presenting to primary care with acute, undifferentiated illness, linked to routine data via SAIL (Wales) and NHS Digital (England). Outcomes (as above, plus features of mcUTI) for children with an mcUTI in this data set, identified through systematic urine sampling, will be compared with those with an mcUTI identified through routine urine sampling (data set 1).
Ethics And Dissemination:
The study protocol has been approved by NHS Wales Research Ethics Committee and the Health Research Authority's Confidentiality Advisory Group. Methods of innovative study design and findings will be disseminated through peer-review journals and conferences. Results will be of interest to clinical and policy stakeholders in the UK.
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