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Clinical characteristics of pediatric febrile urinary tract infection in Japan
Takuma Ohnishi1, Yoshinori Mishima2, Nozomi Matsuda3
1Department of Pediatrics, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan; Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Insights
Febrile urinary tract infections (fUTI) are common in children. This study found a male predominance in Japanese pediatric fUTI cases, especially in infants, with Enterococcus spp. as a significant pathogen.
Area of Science:
- Pediatric infectious diseases
- Urology
- Microbiology
Background:
- Febrile urinary tract infection (fUTI) is a common serious bacterial infection in children.
- Limited research exists on the clinical features of pediatric fUTI in Japan.
- This study addresses the need for data on fUTI in Japanese children.
Purpose of the Study:
- To describe the clinical characteristics of febrile urinary tract infections (fUTI) in Japanese children.
- To identify common pathogens and demographic trends in pediatric fUTI.
- To inform clinical practice and future research in Japan.
Main Methods:
- A multicenter, retrospective, observational study was conducted across 21 Japanese hospitals.
- Included were children under 15 years diagnosed with fUTI between 2008 and 2017.
- Diagnostic criteria included fever >38°C and a single bacterial pathogen in urine culture.
Main Results:
- 2,049 children were analyzed, with a median age of 5 months.
- A male predominance was observed (59.3%), with most males and females under 1 year old.
- Escherichia coli (76.6%) and Enterococcus spp. (9.8%) were the primary causative pathogens.
Conclusions:
- Male infants showed a higher incidence of fUTI in Japan.
- Enterococcus spp. identified as the second most frequent pathogen.
- Recommends Gram staining of urine prior to antibiotic treatment for pediatric fUTI.
Background:
Febrile urinary tract infection (fUTI) is the most common serious bacterial infection in children. Despite this, there have been no studies examining the clinical features of pediatric fUTI in Japan. The purpose of this study was to describe the clinical characteristics of fUTI in Japanese children.
Methods:
A multicenter, retrospective, observational study was conducted at 21 hospitals in Japan. Children under the age of 15 years who were diagnosed with fUTI between 2008 and 2017 were included. The diagnostic criteria were a temperature over 38 °C and the presence of a single bacterial pathogen in urine culture. Patient characteristics were obtained from medical records.
Results:
In total, 2,049 children were included in the study. The median age was 5 months, and 59.3% were male. It was found that 87.0% of the males and 53.2% of the females were under 1 year of age. The main causative pathogens identified were Escherichia coli and Enterococcus spp., accounting for 76.6% and 9.8% of infections, respectively.
Conclusions:
There was a male predominance of fUTI in Japanese children, particularly in infants. Enterococcus spp. were the second most frequent causative pathogen; therefore, Gram staining of urine samples is strongly recommended before initiating antibiotic therapy.
