Ultrasonography Results in First Urinary Tract Infection During Childhood: Which Age Group Should Be Screened?

To determine the frequency of urinary system anomaly in children aged 0-18 y suffering from first urinary tract infection (UTI) and to establish which age group requires urinary ultrasonography (USG) screening.

Age and gender, urine culture, urinary USG, and urological imaging results among 247 children in the 0-18 y age group with a first diagnosis of UTI were investigated retrospectively.

Anomaly was detected at USG in 68 (27.5%) of the 247 patients suffering from first UTI. The most common anomaly was hydronephrosis. Non-E. coli micro-organisms were the pathogenic agents in 61.8% of patients with anomalies detected at USG. Being in the 0-5 y age group (OR: 0.524, 95% CI 0.284-0.970, p = 0.040) and presence of atypical UTI (OR: 4.746, 95% CI: 1.675-13.450, p = 0.003) emerged as independent predictive markers of severe urinary system pathologies on multiple regression analysis.

Based on the data in the present study, routine USG screening is recommended for children suffering from first UTI under the age of 5 y and for the children suffering from atypical UTI at all ages.