title: Factors Associated with Abnormal Imaging and Infection Recurrence after a First Febrile Urinary Tract Infection in Children.
abstract: IntroductionWe determined factors associated with abnormal imaging and recurrent infections after a first febrile urinary tract infection (UTI) in children younger than 3 years.Materials and MethodsWe retrospectively reviewed the records of all patients treated at our institute during the years 2000-2009, for a first febrile UTI in children younger than 3 years, who underwent ultrasonography and voiding cystourethrography. We evaluated data regarding factors potentially associated with abnormal ultrasonography and voiding cystourethrography results and recurrence of infections, and formulated a risk score system to assess risk of reflux and high-grade reflux.ResultsThere were 282 patients. The only factor predicting abnormal ultrasonogram was non-Escherichia coliinfection. Risk factors for vesicoureteral reflux included abnormal ultrasonogram, atypical infection, non-E. coliinfection and infection recurrence. Patients with no identified risk factors for vesicoureteral reflux were unlikely to have high-grade reflux. Higher risk scores were associated with a higher risk for reflux. Non-E. coliinfection was the only statistically significant predictor of infection recurrence.ConclusionAll children younger than 3 years with first febrile UTI should undergo ultrasonography. Thereafter, patients with no predictive factors for vesicoureteral reflux may be followed up without further imaging. A non-E. coliinfection is associated with reflux and infection recurrence.
authors: Department of Pediatric Surgery, Turku University Hospital, Turku, Varsinais-Suomi, Finland.
authors: Marko Tapani
authors: MT
authors: Ristola
authors: Department of Biostatistics, Turku University Hospital, Turku, Varsinais-Suomi, Finland.
authors: Eliisa
authors: E
authors: Löyttyniemi
authors: Department of Pediatric Surgery, Turku University Hospital, Turku, Varsinais-Suomi, Finland.
authors: Timo
authors: T
authors: Hurme
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002444:Cefuroxime / Q000008:administration & dosage; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime