First urinary tract infections in children: the role of the risk factors proposed by the Italian recommendations

Acta Paediatrica
I AlbericiGiovanni Montini

Abstract

In 2009, the Italian society for paediatric nephrology suggested the need for cystography, following a first febrile urinary tract infection (UTI), only in children at high risk for dilating vesicoureteral reflux or in the event of a second infection. The aim of this study was to evaluate the adequacy of the risk factors proposed by the Italian guidelines. Children aged 2-36 months, managed by 10 Italian hospitals between 2009 and 2013, with a first febrile UTI were retrospectively evaluated. Four hundred and fourteen children were included: 51% female, mean age eight months. Escherichia coli was responsible of 84% UTIs. 269 children (65%) presented at least one risk factor, thus were further investigated: 44% had a reflux. The presence of a pathogen other than E. coli significantly predicted high-grade reflux, both in the univariate (Odd Ratio 2.52, 95% Confidence Interval 1.32-4.81, p < 0.005) and multivariate analysis (OR 2.74, 95% CI: 1.39-5.41, p: 0.003). 26/145 children (18%) with no risk factors experienced a second UTI, which prompted the execution of cystography, showing a dilating reflux in 11. Among the risk factors proposed by the Italian guidelines, only the presence of a pathogen other than E. coli significantly p...Continue Reading

References

Jun 23, 2001·The Pediatric Infectious Disease Journal·M E JantunenH Saxén
Jul 6, 2007·BMJ : British Medical Journal·Giovanni MontiniGraziella Zacchello
Nov 30, 2011·Acta Paediatrica·Anita AmmentiUNKNOWN Italian Society of Pediatric Nephrology
Oct 14, 2014·Nephrology·Steven McTaggartGabrielle Williams
Oct 22, 2014·Paediatrics & Child Health·Joan L RobinsonUNKNOWN Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Community Paediatrics Committee
Dec 3, 2014·Urology·Arzu KovanlikayaPaula W Brill
Dec 6, 2014·European Urology·Raimund SteinSerdar Tekgül
Aug 5, 2015·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·William MorelloGiovanni Montini

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Citations

Aug 28, 2019·Acta Paediatrica·Anita AmmentiUNKNOWN Italian Society of Pediatric Nephrology
Sep 29, 2019·Acta Paediatrica·Kjell Tullus
Apr 24, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ian Hewitt, Giovanni Montini
Jan 23, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Marco PennesiEster Conversano
Mar 24, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Anders BreinbjergSøren Rittig
Sep 29, 2020·Journal of Pediatric Urology·Sarah A HolzmanH Gil Rushton

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