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Published on: August 5, 2010
Urinary tract infection in children
Insights
Investigating children with positive urine cultures promptly is crucial. Early detection of urinary tract abnormalities, especially in infants, significantly improves treatment outcomes and prevents kidney scarring.
Area of Science:
- Pediatric Surgery
- Urology
- Nephrology
Background:
- Urinary tract infections (UTIs) are common in children.
- Prompt investigation of UTIs is essential for early diagnosis of underlying abnormalities.
- Recurrent infections may indicate more significant pathology.
Purpose of the Study:
- To prospectively investigate children with positive urine cultures.
- To determine the prevalence of treatable abnormalities in this cohort.
- To analyze the long-term outcomes of medical and surgical interventions.
Main Methods:
- Prospective recording of 572 children with positive urine cultures referred to a pediatric surgical clinic (1968-1977).
- Evaluation for abnormalities requiring treatment.
- Follow-up analysis of treatment results over 5-15 years.
Main Results:
- 45% of investigated children had an abnormality requiring treatment.
- Children referred after a single infection had a higher yield of positive findings and need for surgery compared to those with recurrent infections.
- 90% of children under 2 years old had an abnormality.
- One-third of children with vesicoureteric reflux presented with renal scarring at initial assessment.
Conclusions:
- Urine culture should be performed whenever a urinary infection is suspected in children.
- Immediate investigation of positive urine cultures is vital for timely diagnosis and management.
- Early detection and treatment can prevent long-term complications like renal scarring.
Abstract:
During 1968-77, 572 consecutive children with one or more positive urine cultures who were referred by their family doctors to one paediatric surgical outpatient clinic were investigated and prospectively recorded. An abnormality requiring treatment was found in 45%. The yield of positive findings and need for operation were greater in those referred after one infection than in those with recurrent infection. Among those under 2 years old 90% had an abnormality. One third of children with vesicoureteric reflux showed renal scarring at the time of first attendance. The results of medical and surgical treatment over five to 15 years of follow up were analysed. They emphasised the importance of culturing the urine whenever there may be urinary infection in a child and of investigating immediately those with a positive urine culture.
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