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Culture-positive urinary tract infection following micturating cystourethrogram in children
Simeon Ngweso1,2, Munyaradzi Nyandoro1, Tatenda Nzenza2,3
1Fiona Stanley Hospital. Murdoch, Western Australia, Australia.
Insights
The incidence of culture-positive urinary tract infection (UTI) following micturating cystourethrogram (MCUG) is low at 1.4%. Patients with a history of UTI or neurogenic bladder face increased risk.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Radiology
Background:
- Urinary tract infections (UTIs) are common in children.
- Micturating cystourethrogram (MCUG) is a diagnostic imaging procedure used to evaluate UTIs.
- The risk of developing a UTI after MCUG requires further investigation.
Purpose of the Study:
- To determine the incidence of culture-positive UTIs post-MCUG.
- To identify risk factors associated with developing a UTI after MCUG in pediatric patients.
Main Methods:
- Retrospective review of medical records.
- Analysis of 500 pediatric patients who underwent MCUG.
- Statistical analysis including multivariate logistic regression.
Main Results:
- A low incidence of 1.4% for culture-positive UTIs within 14 days post-MCUG was observed.
- Significant risk factors identified include female sex, neurogenic bladder, and prior UTIs.
- History of UTI (OR: 5.0) and neurogenic bladder (OR: 4.2) were independent predictors of post-MCUG UTI.
Conclusions:
- The incidence of UTI following MCUG is low.
- Neurogenic bladder and previous UTIs are significant independent risk factors.
- Prospective studies are needed to evaluate prophylactic antibiotics for high-risk patients.
Objective:
To determine the incidence of culture-positive urinary tract infection (UTI) after micturating cystourethrogram (MCUG). We further wanted to identify risk factors for developing a culture-positive UTI following MCUG.
Methods:
A retrospective review of the available medical records of 500 paediatric patients who underwent MCUG in Perth, Western Australia was performed.
Results:
Seven (1.4%) patients comprised of four females and three males developed a febrile, culture-positive UTI within 14 days following MCUG. Significant association was found for female patients, patients with neurogenic bladder, and patients with previous culture-positive UTI as developing a culture-positive UTI following MCUG. Multivariate logistic regression determined that patients were more likely to develop culture-positive UTI within 14 days following MCUG if they had a known history of UTI (odds ratio: 5.0, 95% confidence interval: 1.5-17.3, p=0.010) or had a neurogenic bladder (odds ratio: 4.2, 95% confidence interval: 1.0-17.9, p=0.049).
Conclusion:
The incidence of patients who developed a febrile, culture-positive UTI following MCUG was low at 1.4%. Statistically significant and independent associations for the development of culture positive UTI were found in patients with neurogenic bladder and patients with previous culture-positive UTI. Further prospective studies are necessary to determine necessity of prophylactic antibiotics for high-risk patients, e.g., patients with neurogenic bladder or previous culture-positive UTI.
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