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[Recurrent bacteriuria in children]
Insights
Recurrent bacteriuria in children often stems from urologic issues like residual urine. Despite treatment, relapses are common, especially in males with severe abnormalities, necessitating thorough urologic evaluation and follow-up.
Area of Science:
- Pediatric Nephrology
- Pediatric Urology
- Infectious Diseases
Background:
- Recurrent bacteriuria poses a significant challenge in pediatric care.
- Escherichia coli is the predominant pathogen in pediatric urinary tract infections.
- Urological abnormalities are frequently associated with recurrent bacteriuria in children.
Purpose of the Study:
- To investigate the characteristics and outcomes of recurrent bacteriuria in pediatric patients.
- To identify the primary causes and associated urological findings.
- To evaluate the effectiveness of current treatment modalities and propose prognostic groups.
Main Methods:
- A longitudinal study of 54 children with recurrent bacteriuria.
- Detailed urological examinations and microbiological analysis.
- Assessment of treatment response and long-term follow-up (12-97 months).
Main Results:
- Ninety percent of patients exhibited urological abnormalities, with vesicoureteral reflux being most common.
- Residual urine was identified as a major contributing factor to recurrent infections.
- Over 50% of patients experienced relapses despite antibiotic and surgical interventions.
Conclusions:
- Recurrent bacteriuria in children is strongly linked to underlying urological conditions.
- Early and comprehensive urological assessment is crucial for effective management.
- Prognosis varies based on uropathy and renal function, requiring tailored follow-up strategies.
Abstract:
Fifty-four children admitted to the Children's Hospital of Cordoba City with recurrent bacteriuria were followed for 12 to 97 months. Most of them were females and Escherichia coli was the most frequent microorganism isolated in recurrent attacks of bacteriuria. Ninety percent of the patients showed urological abnormalities. Vesicoureteral reflux was the most frequent. Residual urine was considered the main cause of recurrent bacteriuria. After antibioticotherapy and surgical treatment, over one half of the patients persisted with relapses. Recurrent bacteriuria appeared more frequently in male infants with severe urologic abnormalities. Finally, three groups of patients in relation to uropathy and functional renal impairment are described and a different prognosis for each one is proposed. For this reason, each patient must have a complete urologic examination done at the onset and a carefull follow-up, carried out.