Risk factors for urinary tract infection in children: a population-based study of 2856 children.
OBJECTIVE
To identify risk factors for urinary tract infection (UTI) in children to inform the development of preventative strategies.


METHODS
A validated questionnaire covering demographic factors, perinatal, developmental, bowel and urinary history was sent to a cross-sectional sample of parents of elementary school children randomly selected from the first 4 years of school. UTI was ascertained by parental report, verified by cross-referencing with microbiological reports for all positive cases and 50 randomly selected negative cases.


RESULTS
Parents of 2856 children (mean age 7.3 years, range 4.8-12.8 years) responded. A total of 3.6% of children had a bacteriologically verified UTI, compared with 12.6% by parental report alone. Multivariate polychotomous logistic regression showed that a history of structural kidney abnormalities (odds ratio (OR) 15.7, 95% confidence interval 8.1-30.4), daytime incontinence (OR 2.6, 1.6-4.5), female gender (OR 2.4, 1.5-3.8), and encopresis (OR 1.9, 1.1-3.4) were independently associated with UTI. Daytime incontinence increased risk more in boys (8.3% vs. 1.2%) than girls (8.1% vs. 4.6%), and kidney problems increased risk in older compared with younger children (29% vs. 2% in > or =8 year olds, 0% vs. 4% in 4-6 year olds).


CONCLUSIONS
Parents over-report UTI by about threefold. Effective treatment of daytime urinary incontinence and encopresis may prevent UTI in children, especially boys.
Sureshkumar
Premala
P
Centre for Kidney Research, NHMRC Centre for Clinical Research Excellence, The Children's Hospital at Westmead, Australia. premalas@chw.edu.au
Jones
Mike
M
Cumming
Robert G
RG
Craig
Jonathan C
JC
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*