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Acute Pyelonephritis II: Diagnostic Studies and Management

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...

Pharmacokinetics in Pediatric Patients: Drug Excretion

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...

Acute Pyelonephritis I: Introduction

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...

Pneumonia IV: Management

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The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
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Pneumonia I: Introduction

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
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Pharmacokinetics in Pediatric Patients: Drug Metabolism

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...

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Related Experiment Video

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Recurrent Escherichia coli Urinary Tract Infection Triggered by Gardnerella vaginalis Bladder Exposure in Mice

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Published on: December 4, 2020

Beyond the First Infection: Exploring Recurrence in Pediatric Acinetobacter Cases.

Metehan Yaşar Tekin¹, Saliha Kanik-Yüksek², Belgin Gülhan³

¹From the Department of Pediatrics.

The Pediatric Infectious Disease Journal

|March 4, 2026

Summary

Recurrent Acinetobacter infections (AIs) in children lead to longer hospital stays and higher mortality. Identifying at-risk pediatric patients with underlying conditions is crucial for better management and improved outcomes.

Keywords:

mortality multidrug resistance pediatric infections recurrent infection risk factors

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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA

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Area of Science:

Pediatric Infectious Diseases
Clinical Microbiology
Hospital Epidemiology

Background:

Recurrent Acinetobacter infections (AIs) present significant therapeutic challenges and increase healthcare costs.
Data on recurrent pediatric AIs are limited, necessitating characterization for effective management.

Purpose of the Study:

To define the clinical and microbiological characteristics of recurrent Acinetobacter infections in pediatric patients.
To identify risk factors associated with recurrent AIs and their impact on outcomes.

Main Methods:

Retrospective review of pediatric patients (0-18 years) hospitalized with confirmed AI between 2019-2024.
Definition of recurrent AI: new episode within 90 days post-recovery with negative cultures.
Analysis of clinical, microbiological, laboratory data, treatments, and outcomes.

Main Results:

15.3% of 150 pediatric AI patients developed recurrent infections, linked to port-catheter and bloodstream infections.
Recurrent AI was associated with longer hospital stays and increased mortality (47.8% vs. 34.7% overall).
Multidrug- or extensively drug-resistant isolates were common (66.7%); risk factors for mortality included ICU admission and specific lab findings.

Conclusions:

Recurrent pediatric AIs significantly increase hospitalization duration and mortality risk.
Identifying high-risk pediatric patients, especially those with comorbidities and critical illness, is vital.
Enhanced monitoring and targeted interventions are essential for improving outcomes in recurrent pediatric AI cases.