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Related Concept Videos

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

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In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
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Acute Pyelonephritis I: Introduction01:27

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

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Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
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Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
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Continuous antibiotic prophylaxis in isolated prenatal hydronephrosis.

Joshua D Chamberlin1, Luis H Braga2, Carol A Davis-Dao3

  • 1Loma Linda University, Department of Pediatric Urology, Loma Linda, CA, USA; CHOC Children's, Division of Pediatric Urology, Orange, CA, USA.

Journal of Pediatric Urology
|May 7, 2022
PubMed
Summary

Continuous antibiotic prophylaxis (CAP) did not significantly reduce urinary tract infection (UTI) rates in children with isolated prenatal hydronephrosis (PNH). Clinicians should assess individual risk factors before prescribing CAP for PNH patients.

Keywords:
Antibiotic prophylaxisHydronephrosisUrinary tract infections

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Area of Science:

  • Pediatric Urology
  • Congenital Anomalies
  • Infectious Disease Prevention

Background:

  • Prenatal hydronephrosis (PNH) is a common congenital anomaly.
  • PNH increases the risk of urinary tract infections (UTIs) in early childhood.
  • Continuous antibiotic prophylaxis (CAP) is controversially used to prevent UTIs in children with PNH.

Purpose of the Study:

  • To determine the incidence of UTIs in children with isolated PNH.
  • To compare UTI rates in children with isolated PNH who received CAP versus those who did not.
  • To evaluate the effectiveness of CAP in preventing UTIs in this population.

Main Methods:

  • A cohort study of 801 children with isolated PNH from the Society for Fetal Urology Hydronephrosis Registry (2008-2020).
  • Inclusion criteria: isolated renal pelvis dilation without ureteral or bladder abnormalities.
  • Primary outcome: development of UTI, comparing CAP users and non-users, with adjustments for confounding factors.

Main Results:

  • The overall UTI rate in children with isolated PNH was 4.2%.
  • CAP use was not associated with a significant reduction in UTI risk (4.0% with CAP vs. 4.3% without CAP; P=0.76).
  • Independent predictors of UTI included female sex, intact prepuce, and high-grade hydronephrosis.

Conclusions:

  • The overall UTI rate in children with isolated PNH is low.
  • CAP did not demonstrate a significant benefit in reducing UTI risk in this cohort.
  • Clinical decisions regarding CAP for isolated PNH should consider individual patient risk factors.