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Urinary infection and malformations of urinary tract in infancy
Insights
Urinary tract infections (UTIs) in infants show significant age and sex differences. Many urinary tract malformations are diagnosed post-UTI, despite prenatal screening efforts.
Area of Science:
- Pediatrics
- Urology
- Medical Imaging
Background:
- Urinary tract infections (UTIs) are common in infants.
- Understanding demographic and malformation patterns is crucial for early diagnosis and management.
- Prenatal diagnosis of urinary tract anomalies is increasing.
Purpose of the Study:
- To investigate age and sex differences in infants experiencing their first UTI.
- To compare the diagnostic timing of urinary tract malformations (UTMs) between prenatal evaluation and post-UTI diagnosis.
- To assess the impact of prenatal diagnosis on the incidence of UTMs identified after UTI.
Main Methods:
- Retrospective analysis of 140 infants with their first UTI.
- Evaluation of patient demographics (age, sex) and associated urinary tract conditions.
- Comparison of prenatally diagnosed UTMs with those identified following UTI diagnosis.
Main Results:
- Two-thirds of infants had their first UTI within the first three months of life, with boys being younger.
- Boys showed a higher incidence of obstructive uropathies, particularly in the first two months.
- Vesicoureteric reflux incidence was similar between sexes; obstructive uropathies and multicystic dysplastic kidneys were more frequently diagnosed prenatally, while most reflux cases were diagnosed post-UTI.
Conclusions:
- Significant age and sex disparities exist in infant UTIs.
- Despite advances in prenatal diagnosis, many urinary tract malformations are still identified after the onset of UTI in infancy.
- Early identification of UTI in infants remains critical for detecting associated malformations.
Abstract:
One hundred and forty infants with their first urinary tract infections were studied and pronounced differences in age and sex were found. Two thirds of the patients had their first urinary tract infection during the first three months of life, and boys were significantly younger. There was a predominance of boys from 1-3 months old, but of girls thereafter. Obstructive uropathies occurred more often in boys, and during the first two months of life. The incidence of vesicoureteric reflux was similar for both sexes. Malformations recognised after urinary tract infections were compared with urinary tract malformations recognised prenatally. Fetal urinary tracts were evaluated in just over half of all pregnancies during the study period. Obstructive uropathies and multicystic dysplastic kidneys were more often diagnosed prenatally, and most refluxes were diagnosed after the urinary tract infection. In conclusion age and sex differences are common in urinary tract infection, and even though many urinary tract malformations were diagnosed prenatally this did not influence the high incidence of malformations recognised after urinary tract infection in infancy.