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Urinary infection in infants and preschool children. Five-year follow-up
Insights
Urinary tract infections (UTIs) are common in infants and preschool children. Early detection and management are crucial, especially in infants with high-risk urinary tract abnormalities, to prevent kidney damage.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Urology
Background:
- Urinary tract infections (UTIs) pose a significant health concern in pediatric populations.
- Understanding the prevalence and long-term implications of UTIs in infants and preschool children is essential for effective management.
Purpose of the Study:
- To investigate the prevalence of symptomatic and asymptomatic urinary infections in a large cohort of infants and preschool children.
- To assess the incidence of upper tract damage and vesicoureteral reflux in children with UTIs.
- To evaluate the association between urinary tract abnormalities and recurrent infections or kidney damage.
Main Methods:
- A longitudinal study involving 1,617 infants and 1,711 preschool children.
- Monitoring for symptomatic and asymptomatic urinary infections over a three to five-year follow-up period.
- Roentgenographic evaluation to identify upper tract damage and vesicoureteral reflux in affected children.
Main Results:
- Asymptomatic bacteriuria was observed in 1.8% of female infants, 0.5% of male infants, and 0.8% of preschool girls.
- Seventeen percent of infants and 13% of preschool children with UTIs showed upper tract damage; 46% of infants and 9% of preschool children had vesicoureteral reflux.
- Infants with high-risk urinary tract lesions exhibited substantial bacteriuria.
Conclusions:
- Urinary tract infections are prevalent in young children, with varying rates of asymptomatic bacteriuria.
- A significant proportion of children with UTIs, particularly infants, present with upper tract damage and vesicoureteral reflux.
- Infants with specific urinary tract abnormalities are at higher risk for bacteriuria and potential complications.
Abstract:
A group of 1,617 infants and 1,711 preschool children were studied for symptomatic and asymptomatic urinary infection and followed up for three to five years. Asymptomatic bacteriuria was found in 1.8% of female infants, 0.5% of male infants, 0.8% of preschool girls, and none of the preschool boys. Seventeen percent of the infants and 13% of the preschool children with urinary infection studied roentgenographically had upper tract damage; 46% of the infants and 9% of the preschool children had vesicoureteral reflux. Infants with normal urinary tracts and urinary infection with or without reflux tended to have recurrent infection, whereas the kidneys remained anatomically normal. The infants with high-risk lesions, such as obstructive uropathy and vesicoureteral junction ectopia and deformity, had substantial bacteriuria on screening culture.