Predictors of Urinary Abnormalities in Children Hospitalised for Their First Urinary Tract Infection

Area of Science:

• Pediatrics
• Infectious Diseases
• Urology

Background:

• Urinary tract infections (UTIs) are common in children.
• Identifying risk factors for urinary abnormalities in children with their first UTI is crucial for timely intervention.
• Concomitant bacteremia in children with UTI may indicate a higher risk profile.

Purpose of the Study:

• To investigate the association between positive blood cultures in children with their first UTI and the risk of urinary abnormalities.
• To identify specific clinical and microbiological factors associated with urinary abnormalities in this pediatric population.

Main Methods:

• Retrospective study of 161 children younger than 18 years with their first UTI.
• Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis were employed.
• Evaluation of age, blood culture results, and urine culture findings (including specific pathogens) as predictors of urinary abnormalities.

Main Results:

• Older age (p=0.001), positive blood cultures (p=0.001), and the presence of Pseudomonas aeruginosa or unusual germs in urine (p=0.002) were significantly associated with urinary abnormalities.
• A predictive model incorporating these factors achieved an AUC of 0.7168 for detecting urinary malformations (p=0.0315).

Conclusions:

• Children hospitalized for their first UTI episode who have a positive blood culture, are older, or have unusual bacteria in their urine are at significantly higher risk for urinary abnormalities.
• These findings support the development of personalized screening strategies for urinary abnormalities in pediatric UTI cases.
• The study highlights the importance of considering blood culture status and specific urine pathogens in the risk assessment for urinary tract abnormalities.