scholarly journals Frequency of Vesicoureteral Reflux in Children having Recurrent Urinary Tract Infections

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Irum Aslam ◽  
Muhammad Asif Siddiqui ◽  
Fatima Zia ◽  
Hafsa Qamar

Objective: Repeated urinary tract infections are significantly related to anatomical abnormalities of urinary tract. Vesicoureteral reflux is quite common, under diagnosed anatomical abnormality, leads to renal scarring and chronic kidney disease. The objective of the study was to determine the frequency of vesicoureteral reflux in children having repeated urinary tract infections. Methods: It is cross sectional survey conducted in department of Pediatric Medicine, The Children's Hospital & Institute of Child Health, Lahore, spanning from 20-5-2014 to 19-11-2014, using non-probability purposive sampling, a total of 140 patients included. Each child was screened and followed with repeated urinary tract infections for frequency of vesicoureteral reflux by detailed clinical examination and relevant investigation as defined in operational definition. To avoid any controversy, all the findings of UTI & vesicoureteral reflux was assessed by a single consultant. Data was managed using SPSS version 20. Results: In this study the mean age of all patients was 5.64±2.35 years. There were 42 (30%) males and 98(70%) females in this study with male to female ration 1:233. The mean number of episodes of urinary tract infections was 5.82±1.95 per years. Frequency of vesicoureteral reflux in these patients was seen in 35(25%) of the patients. When we stratified the data over age, gender and number of episodes of urinary tract infection we found significant association of vesicoureteral reflux with age groups only (p-value < 0.05) while no association between vesicoureteral reflux versus gender and number of episodes of urinary tract infection (p- value > 0.05). Conclusion: We found significant correlation between vesicoureteral reflux and repeated urinary tract infections. Cases with repeated urinary tract infections should be investigated thoroughly to address underlying cause, in order to prevent renal damage and long-term complications. Key Words: Paediatric, Urinary tract infections, hydronephrosis, Vesicoureteral reflux How to Cite: Aslam I, Siddiqui MA, Zia F, Qamar H. Frequency of vesicoureteral reflux in children having recurrent urinary tract infections. Esculapio.2020;16(04):18-20.

1971 ◽  
Vol 16 (12) ◽  
pp. 506-508 ◽  
Author(s):  
H. Gavras ◽  
D. H. Lawson ◽  
A. L. Linton

Thirty patients with recurrent urinary tract infections who had failed to respond to previous extended treatment with Sulphadimidine and/or Ampicillin were treated with a Trimethoprim-sulphamethoxazole combination ‘Septrin’. Twenty six per cent developed allergic reactions. In those who completed a 3-months' course there was a 59 per cent success rate in eradicating bacteriuria at a 6-months follow-up.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S832-S833
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Fatma Smaoui ◽  
...  

Abstract Background Bacterial urinary tract infections continue to be a major health problem, responsible for a significant morbidity and mortality. Its prognosis is more severe than non-bacterial forms. The aim of this work was to study the clinical and evolutionary features of bacterial urinary tract infections caused by Escherichia coli (E.coli). Methods We conducted a retrospective study including all patients hospitalized in infectious diseases department for urinary tract infection (UTI) caused by E.coli between 2010 and 2017. Results During the study period, we enrolled 613 cases of UTI caused by E.coli, among whom 75 cases (12.2%) were bacterial. There were 47 females (62.7%). The mean age was 59 ±17 years. Thirty-three patients were aged ≥ 65 years (44%). Diabetes was noted in 38 cases (50.7%) and renal lithiasis in 14 cases (18.7%). A history of UTI was reported in 13 cases (17.3%). The most common clinical presentation was acute pyelonephritis (59 cases; 78.7%) and followed by prostatitis (8 cases; 10.6%). Renal abscess was noted in 5 cases (6.7%) and prostatic abscess in 3 cases (4%). There were 36 cases of multidrug-resistant bacteria (48%). Community-acquired UTI were noted in 70 cases (93.3%). The mean duration of treatment was 18 ± 6 days. Surgery and radiological drainage were indicated in 4 (5.3%) and 2 cases (2.7%), respectively. The outcome was favourable in 58 cases (77.3%). Complications were noted in 10 cases (13.3%) represented mainly by acute renal failure in 4 cases (5.3%). Relapse was noted in 9 cases (12%) and reinfection in 6 cases (8%). Two patients died (2.7%). Conclusion Bacterial urinary tract infections were associated to complications such as renal and prostatic abscess, requiring surgery and long duration of treatment. Disclosures All Authors: No reported disclosures


2020 ◽  
Vol 16 (4) ◽  
pp. 377-381
Author(s):  
Anna Wachnicka-Bąk ◽  
◽  
Agata Będzichowska ◽  
Katarzyna Jobs ◽  
Bolesław Kalicki ◽  
...  

Introduction: Urinary tract infections are the second most common type of bacterial infection in children. Atypical infections may be associated with a higher future risk of chronic kidney disease. The current range of diagnostic tests in children with a history of urinary tract infections is still a subject of discussions. Aim of the study: We attempted to determine the indications for renal scintigraphy and develop a nephrological care model for children aged ≤24 months based on the analysis of urinary tract infections in this group of patients. Materials and methods: We included 61 children aged ≤24 months [42 (68%) girls and 19 (32%) boys], hospitalised in the Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine in Warsaw from 2008 to 2015 due to their first episode of urinary tract infection, in our retrospective analysis. Depending on the result of DMSA static renal scintigraphy performed 6 months after completed treatment of urinary tract infection, patients were classified into 3 groups: normal scintigraphy (group I), irregular tracer uptake indicating a suspicion of post-inflammatory renal pole lesions (group II), and signs of hypodysplasia (group III). The following variables were compared: age at first infection, gender, fever, inflammatory markers, aetiology, ultrasonographic findings, and the results of voiding cystourethrography for vesicoureteral reflux. Results: The median age at the time of first infection was 5.5 months in group I, 7 months in group II, and 7.5 months in group III. Febrile urinary infection was reported in 6/21 patients in group I, 4/19 patients in group II, and 6/21 patients in group III. Increased C-reactive protein was observed in 7/21 patients in group I, 6/19 patients in group II, and 6/21 patients in group III. Recurrent infections were reported for 5/21 children in group I, 8/19 in group II, and 12/21 children in group III. Atypical aetiology of urinary infection was reported for 3/21 patients in group I, 2/19 in group II, and 2/21 in group III. Abnormal ultrasonographic findings were observed in 4/21 patients in group I, 1/19 patients in group II, and 4/21 patients in group III. Vesicoureteral reflux in voiding cystourethrography was reported in 5/21 patients in group I, 8/19 patients in group II, and 10/21 patients in group III. The analysis of all the investigated parameters showed no statistically significant differences between the groups. Conclusions: Renal scintigraphy should be performed in the youngest children with a history of urinary tract infection as it was not possible to identify patients with post-inflammatory renal scarring secondary to urinary tract infection based on the course of infection, its aetiology, ultrasound findings and the presence of vesicoureteral reflux. Ultrasonography was not sensitive enough to diagnose renal hypodysplasia in our group of children.


Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1055
Author(s):  
Dominique E. Werter ◽  
Brenda M. Kazemier ◽  
Caroline Schneeberger ◽  
Ben W. J. Mol ◽  
Christianne J. M. de Groot ◽  
...  

Symptomatic urinary tract infections are associated with preterm birth. However, data on risk indicators for urinary tract infections are limited and outdated. The research is a secondary analysis. The study was a prospective multicenter cohort study of low-risk pregnant women. Logistic regression was used to identify risk indicators for urinary tract infections. The incidence of urinary tract infections was 9.4%. Multivariate logistic regression showed that a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria in the present pregnancy were associated with urinary tract infections (resp. OR 3.14, 95%CI 1.40–7.02 and OR 1.96 95%CI 1.27–3.03). Women with a urinary tract infection were at increased risk of preterm birth compared to women without a urinary tract infection (12 vs. 5.1%; adjusted HR 2.5 95%CI 1.8–3.5). This increased risk was not found in women with the identified risk indicators (resp. 5.3% vs. 5.1%, adjusted HR 0.35 95%CI 0.00–420 and adjusted HR 1.5 95CI% 0.59–3.9). In conclusion, in low-risk pregnant women, risk indicators for urinary tract infections are: a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria. The risk of preterm birth is increased in women with a urinary tract infection in this pregnancy. However, women with recurrent urinary tract infections and asymptomatic bacteriuria this pregnancy appear not to be at increased risk of preterm birth.


Author(s):  
Philipp Dahm ◽  
Jane M. Lewis

This chapter summarizes the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial, a landmark trial that randomized children with vesicoureteral reflux diagnosed after a first or second febrile or symptomatic urinary tract infection to receive trimethoprim–sulfamethoxazole (TMP-SMX) prophylaxis versus placebo. It found that antibiotic prophylaxis reduced the incidence of recurrent febrile or symptomatic urinary tract infection but had little effect on renal scarring. Recurrent febrile or symptomatic urinary tract infections resistant pathogens were increased. This study provides the underpinning for guidelines that advocate for low-dose antibiotic prophylaxis for the first year of life; however, this remains an area of considerable controversy.


Author(s):  
James Trayer ◽  
Michael Horgan ◽  
Anna-Rose Prior ◽  
Martin Ryan ◽  
Montasser Nadeem

AbstractBackground Urinary tract infections are common and require prompt treatment. Objective To examine the resistance rates of co-amoxiclav in children with urinary tract infection and whether antimicrobial resistance is influenced by other variables. Methods The records and antibiotic susceptibility data of 209 patients admitted with symptomatic urinary tract infection between January 2018 and December 2019 were reviewed. Results We examined 209 patients [mean (SD) age 23.73 (32.86) months], of whom 176 (84.2%) had first urinary tract infection. Escherichia coli was isolated in 190 (90.1%). Uropathogens were sensitive to co-amoxiclav in 47.8% of patients and gentamicin in 95.2%. Combined co-amoxiclav with gentamicin demonstrated antimicrobial sensitivity in 96.2%. Antimicrobial resistance was associated with longer hospital stay (p-value < 0.02). An association was identified between co-amoxiclav resistance and recurrent urinary tract infections. Uropathogens were resistant to co-amoxiclav in 80/176 (45.5%) and 29/33 (87.9%) patients with first and recurrent urinary tract infections, respectively (p-value 0.001). No link was observed between antimicrobial resistance and atypical urinary tract infection. Conclusion Approximately half of children in this cohort had urinary tract infection due to uropathogens resistant to co-amoxiclav. Co-amoxiclav resistance is associate with recurrent infections and longer hospital stays. A combination of co-amoxiclav and gentamicin demonstrates > 96% susceptibility.


Author(s):  
Rana M. Abdullah Al-Shwaikh ◽  
Abbas Falih Alornaaouti

       Current study obtained (75) isolate of Pseudomonas aeruginosa collected from different cases included : 28 isolates from otitis media, 23 isolates from burn infections, 10 isolates from wound infections, 8 isolates from urinary tract infections and 6 isolates from blood, during the period between 1/9/2014 to 1/11/2014        The result revealed that the tox A gene was present in 54 isolates (72%) of Pseudomonas aeruginosa. The gel electrophoresis showed that the molecular weight of tox A gene was 352 bp. The result shows 17 isolates (60.71%) from otitis media has tox A gene, 18 isolates (78.26%) from burn followed by 8 isolate (80%) from wound infection and 5 isolates (62.5%) from urinary tract infection , finally 6 isolates (100%) from blood have this gene.


2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection


2017 ◽  
Vol 38 (8) ◽  
pp. 998-1001 ◽  
Author(s):  
Taniece Eure ◽  
Lisa L. LaPlace ◽  
Richard Melchreit ◽  
Meghan Maloney ◽  
Ruth Lynfield ◽  
...  

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.Infect Control Hosp Epidemiol 2017;38:998–1001


2012 ◽  
Vol 11 (1) ◽  
pp. e185
Author(s):  
N.M. Stepanova ◽  
V.E. Driyanska ◽  
V.Y. Kundin ◽  
O.A. Romanenko ◽  
T.I. Berezyak

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