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Ultrasonography Results in First Urinary Tract Infection During Childhood: Which Age Group Should Be Screened?
Davut Kayak1, Mehmet Tekin2, Capan Konca1
1Department of Pediatrics, School of Medicine, Adıyaman University, Adiyaman, 02000, Turkey.
Insights
Routine urinary ultrasonography (USG) screening is recommended for children under 5 years old with their first urinary tract infection (UTI). Atypical UTI cases at any age also warrant USG screening due to potential urinary system anomalies.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are common in children.
- Identifying underlying urinary system anomalies is crucial for effective management.
- Current screening guidelines for urinary anomalies post-UTI vary.
Purpose of the Study:
- To determine the frequency of urinary system anomalies in children experiencing their first UTI.
- To identify age groups that would benefit most from urinary ultrasonography (USG) screening.
Main Methods:
- Retrospective analysis of 247 children (0-18 years) diagnosed with their first UTI.
- Data collected included age, gender, urine culture, urinary USG, and urological imaging results.
- Statistical analysis, including multiple regression, was used to identify predictive markers.
Main Results:
- Urinary system anomalies were detected in 27.5% of children via USG, with hydronephrosis being the most common.
- Non-E. coli pathogens were associated with anomalies in 61.8% of cases.
- Children aged 0-5 years and those with atypical UTIs were identified as independent predictors of severe urinary pathologies.
Conclusions:
- Routine USG screening is recommended for children under 5 years old with their first UTI.
- USG screening is also advised for children of all ages presenting with atypical UTIs.
- Early detection of anomalies through targeted USG can improve pediatric UTI management.
Objectives:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
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