"Parenteral" Diarrhea Associated With Pediatric Urinary Tract Infections: A Retrospective Chart Review

Area of Science:

• Pediatrics
• Infectious Diseases
• Gastroenterology

Background:

• Parenteral diarrhea, noninfectious diarrhea associated with extraintestinal infections like UTIs, has been recognized for over a century.
• Despite historical recognition, empirical evidence supporting the association between UTIs and diarrhea remains limited.

Purpose of the Study:

• To investigate the association between urinary tract infections (UTIs) and reported cases of diarrhea in pediatric patients.
• To determine if UTIs are a significant factor in noninfectious diarrhea among young children.

Main Methods:

• A retrospective chart review was conducted on pediatric patients under five years old diagnosed with culture-positive UTIs between October 2017 and March 2019.
• A control group of children under five with noninfectious complaints (head trauma, fractures) was used to assess the background rate of diarrhea.
• Exclusion criteria included recent urological procedures, known urinary tract or gastrointestinal diseases, immune suppression, or sepsis.

Main Results:

• Diarrhea was reported in 18.6% (44/236) of pediatric patients with culture-positive UTIs.
• Escherichia coli was the most common pathogen in children with both UTIs and diarrhea (72.7%).
• In the control group, diarrhea was reported in only 0.01% (2/368) of patients.

Conclusions:

• The study found a significant association between culture-proven UTIs and reported diarrhea in pediatric patients younger than five years.
• The findings suggest that UTIs may contribute to extraintestinal diarrhea in young children.
• Further prospective studies are recommended to confirm this association and elucidate underlying mechanisms.