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Approach to Pediatric Patients with UTI in the PICU

Kimberly Czech1, Eunice John1

  • 1Department of Pediatric Nephrology, University of Illinois Medical Center at Chicago, Chicago, Illinois, United States.

Journal of Pediatric Intensive Care
|May 22, 2019
PubMed

Insights

Pediatric urosepsis and urinary tract infections (UTI) require prompt diagnosis and management. Key risk factors include young age and congenital renal anomalies, necessitating thorough workup and tailored antibiotic therapy.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Nephrology

Background:

  • Urosepsis and urinary tract infections (UTI) are frequent admissions in pediatric intensive care units (PICU).
  • Risk factors for severe outcomes in pediatric patients include young age, congenital renal anomalies, and immunosuppression (e.g., post-transplant).

Purpose of the Study:

  • To review the diagnostic workup for pediatric urosepsis and UTI.
  • To discuss management strategies for pediatric patients with UTI and urosepsis, considering those with and without urinary tract anomalies.

Main Methods:

  • Review of diagnostic modalities including ultrasound, X-ray cystourethrogram, urodynamic studies, CT, and MRI for identifying renal anomalies.
  • Discussion of management principles: appropriate antibiotic selection, hemodynamic support, and acute kidney injury (AKI) prevention.

Main Results:

  • Early identification of renal anomalies is crucial for effective management.
  • Management requires a multi-faceted approach addressing infection, hemodynamic stability, and renal function.

Conclusions:

  • Comprehensive workup and tailored management are essential for improving outcomes in pediatric patients with urosepsis and UTI.
  • Awareness of potential chronic renal failure in chronically ill children, not solely those with congenital anomalies, is vital.

Keywords:
UTIneurogenic bladderrenal anomaliesrenal transplanturosepsis

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