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[First urinary infection in infants aged less than 3 months. Diagnostic and therapeutic aspects from 44 cases]
Insights
Urinary tract infections in infants under 3 months often present with fever and digestive issues. Early diagnosis and repeated urine cultures are crucial, as E. coli is common and antibiotic resistance is a concern.
Area of Science:
- Pediatrics
- Infectious Diseases
- Urology
Context:
- Urinary tract infections (UTIs) are common in infants.
- Early diagnosis and management are critical for preventing long-term complications.
- Infants under three months present unique diagnostic challenges.
Purpose:
- To analyze the clinical, bacteriological, and radiological features of UTIs in infants under three months.
- To highlight diagnostic difficulties and emphasize the need for accurate urine collection.
- To evaluate treatment outcomes and identify common causative pathogens and their antibiotic resistance patterns.
Summary:
- A retrospective study of 44 infants (<3 months) with UTIs revealed fever and digestive symptoms as primary clinical signs.
- Escherichia coli was the predominant pathogen (88%), with 26% exhibiting ampicillin resistance.
- Radiological abnormalities were found in 46% of infants, with 43% showing lower urinary tract abnormalities (reflux).
- Repeated urine collection is recommended to avoid misdiagnosis due to contamination.
- Ampicillin-based regimens were common, achieving urine sterilization in all cases.
Impact:
- Highlights the importance of considering UTIs in febrile infants with gastrointestinal symptoms.
- Underscores the challenges in pediatric urine sample collection and the need for confirmatory testing.
- Provides data on pathogen prevalence and antibiotic resistance, informing empirical treatment guidelines.
- Identifies a significant rate of urinary tract abnormalities, necessitating further investigation and follow-up.
Abstract:
While studying retrospectively 44 cases in infants less than 3 months with urinary tract infection, clinical, bacteriological and radiological aspects have been analyzed. Clinical symptomatology were chiefly fever and digestive symptoms (anorexia, vomiting) associated with poor weight gain. Among the causative bacteria, E. coli was the most frequent (88%) with ampicillin resistance in 26% of them. Diagnosis difficulties associated with urine collection with a bag, frequently contaminated, have to be emphasized. It is therefore necessary, except in case of emergency to repeat urine collection before treatment. Among 35 infants investigated radiologically, the urinary tract was abnormal in 46% (48% boys and 40% girls). The localization of the abnormality was upper in 16% and lower (reflux) in 43%. Ampicillin alone or associated with an aminoglycoside was the most common treatment (33 cases). Urine sterilization has always been obtained.