Urinary tract infection in pediatrics: an overview

Area of Science:

• Pediatrics
• Infectious Diseases
• Nephrology

Background:

• Urinary tract infection (UTI) is the most frequent bacterial infection in children.
• Pediatric UTIs can signal congenital anomalies of the kidney and urinary tract (CAKUT) or bladder dysfunction.
• Escherichia coli is the predominant pathogen in community-acquired acute pyelonephritis.

Purpose of the Study:

• To critically review the pathogenesis, clinical presentation, diagnosis, imaging, treatment, chemoprophylaxis, and complications of pediatric UTIs.
• To highlight areas of ongoing debate and the need for further research in childhood UTI management.

Main Methods:

• A comprehensive, non-systematic literature search was conducted in public databases.
• Data were independently gathered and reviewed by two authors.

Main Results:

• Pediatric UTI presentation is highly variable and can be subtle.
• Urine culture remains the gold standard for diagnosis; urine collection methods require careful consideration.
• The optimal imaging protocol and the role of antibiotic prophylaxis are subjects of ongoing discussion, with a trend towards reduced prophylaxis but recognition of its benefit in select cases.
• Hypertension and chronic kidney disease are infrequently associated with UTIs in population-based studies.

Conclusions:

• Significant aspects of pediatric UTI management, particularly imaging and antibiotic prophylaxis, require further investigation.
• Longitudinal studies are essential to develop tailored approaches for managing UTIs in children.