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[Age distribution of urinary tract infections (UTIs) and their severity grade in children (author's transl)]
Insights
Urinary tract infections (UTI) present differently in boys and girls. Boys experience severe UTI early, while girls
Area of Science:
- Pediatric Nephrology
- Pediatric Urology
- Infectious Diseases
Background:
- Urinary tract infections (UTI) are common in children, necessitating understanding of their patterns and severity.
- Distinguishing between upper (renal) and lower UTI is crucial for appropriate management and prognosis.
Purpose of the Study:
- To analyze the frequency, severity, and patterns of urinary tract infections in a cohort of children.
- To evaluate the utility of a specific classification system for grading UTI severity and differentiating infection sites.
Main Methods:
- Follow-up study of 339 children (77 boys, 262 girls) with diagnosed UTI.
- Diagnostic imaging included excretory urography and urethrocystography for all participants.
- UTI severity grading utilized the Elo and Stenström classification, based on erythrocyte sedimentation rate (ESR) and white blood cell count (WBC).
Main Results:
- Boys predominantly experienced severe UTI episodes within the first three years of life; occurrences were sporadic thereafter.
- Girls showed severe UTI episodes in early childhood, transitioning to milder, often asymptomatic, infections by age 10.
- The ESR and WBC-based classification effectively differentiated between renal and lower urinary tract infections.
Conclusions:
- Age and sex significantly influence UTI presentation and severity in children.
- The Elo and Stenström classification is a valuable tool for assessing UTI severity and localization.
- Early identification and differentiation of UTI types are essential for pediatric patient outcomes.
Abstract:
Urinary tract infections in 339 children (77 boys and 262 girls) have been followed up. An excretory urography and a urethrocystography were done for all the children. The frequency of functional and anatomical abnormalities is given. The severity grade of UTI was determined according to the classification of Elo and Stenström. Almost all episodes of UTI among boys occurred during the first three years of life and were mostly severe. After the 3rd year of life the occurrence of UTI among the boys was sporadic. Among the girls the severe episodes dominates during the first three years of life, but after that the episodes tended to become milder in character becoming mostly asymptomatic. The peak of asymptomatic episodes among girls was at 10 years of age. After that age the number of episodes dropped abruptly. The classification used, based on the erythrocyte sedimentation rate (ESR) and on white blood cell count (WBC), has shown to be useful and makes it possible to differentiate between renal (pyelonephritic) episodes and the lower tract episodes.