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UTI in children

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https://www.readbyqxmd.com/read/28716390/impact-of-cytokine-genetic-polymorphisms-on-the-risk-of-renal-parenchymal-infection-in-children
#1
Almontaser Hussein, Eman Askar, Ahlam Badawy, Khaled Saad, Asmaa Zahran, Ahmad A Elderwy
BACKGROUND: Acute pyelonephritis is associated with renal scarring in up to 30% of patients. Renal scarring may cause significant long-term morbidity. The pathogenesis of acute pyelonephritis remains unclear, although it involves interaction among uroepithelium, the immune system cells, and the locally produced cytokines. That some UTI-prone children develop acute pyelonephritis, and eventually renal parenchymal scarring, suggests a genetic role. Interleukin-6, interleukin-8, chemokine receptor-1 (CXCR1), and tumor necrosis factor-alpha (TNFα), the key regulators of the host immune responses, are proteins whose secretion is controlled by genes...
July 3, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28713004/results-of-a-prospective-randomized-control-trial-comparing-hydrophilic-to-uncoated-catheters-in-children-with-neurogenic-bladder
#2
William DeFoor, Pramod Reddy, Melissa Reed, Brian VanderBrink, Elizabeth Jackson, Bin Zhang, Julie Denlinger, Paul Noh, Eugene Minevich, Curtis Sheldon
INTRODUCTION: Children with neurogenic bladder (NGB) often require a lifetime of clean intermittent catheterization (CIC), typically using uncoated catheters (UCs). Hydrophilic catheters (HCs) have lower friction than UCs with reported less damage to the urethra. The purpose of this study is to compare outcomes between these catheters. METHODS: An investigator-initiated, prospective, randomized clinical trial was conducted to compare HCs versus UCs. Children aged 2-17 years with NGB on CIC were enrolled for 1 year...
July 4, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28713003/reassessing-the-utility-of-routine-urine-culture-with-urodynamics-uti-incidence-and-risk-factors
#3
Devon C Snow-Lisy, Christopher Halline, Emilie K Johnson, Dawn Diaz-Saldano, Theresa Meyer, Elizabeth B Yerkes
INTRODUCTION: There is no consensus regarding use of periprocedural antibiotics or routine urine cultures during urodynamics study (UDS) in children. At our hospital, we historically have obtained urine cultures during UDS. However, even with positive cultures, few patients require treatment. Most are successfully managed with increased hydration and frequent bladder emptying. PURPOSE: To evaluate clinical characteristics, antibiotic treatment, and outcomes in patients undergoing UDS to identify (1) risk factors for urinary tract infection (UTI) after UDS, and (2) patients who may benefit from routine urine culture...
June 19, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28712168/justification-for-re-look-cystoscopy-after-posterior-urethral-valve-fulguration
#4
Gul Nawaz, Ijaz Hussain, Shujah Muhammad, Muhammad Imran Jamil, Asad Ur Rehman, Nadeem Iqbal, Saeed Akhter
BACKGROUND: Posterior urethral valve (PUV) is life-threatening congenital anomaly of the urinary tract that results in vesicoureteric reflux, recurrent UTI, voiding dysfunction and renal insufficiency if not treat timely. Endoscopic ablation of posterior urethral valves using cold knife or laser is the current gold standard therapy. Many urologists go for repeat cystoscopy to see residual valve or stricture while others repeat VCUG to measure the posterior to anterior urethral ratio for residual obstruction...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28706384/antimicrobial-susceptibility-risk-factors-and-prevalence-of-bla-cefotaximase-temoneira-and-sulfhydryl-variable-genes-among-escherichia-coli-in-community-acquired-pediatric-urinary-tract-infection
#5
Kallyadan V Nisha, Shetty A Veena, Shenoy D Rathika, Shenoy M Vijaya, Shetty K Avinash
INTRODUCTION: The emergence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has become an important challenge among pediatric patients with community-acquired urinary tract infection (UTI). OBJECTIVES: The aim of this study was to assess the antimicrobial susceptibility patterns, associated risk factors and to survey the frequency of bla cefotaximase (CTX-M), bla temoneira (TEM), and bla sulfhydryl variable (SHV) genotypes in ESBL-producing E...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28683358/distinctive-inflammatory-profile-between-acute-focal-bacterial-nephritis-and-acute-pyelonephritis-in-children
#6
Makoto Mizutani, Shunji Hasegawa, Takeshi Matsushige, Naoki Ohta, Setsuaki Kittaka, Madoka Hoshide, Takeshi Kusuda, Kazumasa Takahashi, Kiyoshi Ichihara, Shouichi Ohga
BACKGROUND: Acute focal bacterial nephritis (AFBN) is a severe form of upper urinary tract infection (UTI) with neurological manifestations and focal renal mass lesions on computed tomography (CT). Prolonged antibiotic therapy may improve the renal outcome, but the early differential diagnosis of AFBN from acute pyelonephritis (APN) is challenging. We searched for effective biomarkers of AFBN based on the pathophysiology of upper UTIs. METHODS: Of 52 upper UTI cases treated at Yamaguchi University between 2009 and 2016, 38 pediatric patients with AFBN (n=17) or APN (n=21) who underwent ultrasonography and/or CT were enrolled...
July 3, 2017: Cytokine
https://www.readbyqxmd.com/read/28681079/urinary-tract-infection-in-small-children-the-evolution-of-renal-damage-over-time
#7
Svante Swerkersson, Ulf Jodal, Rune Sixt, Eira Stokland, Sverker Hansson
BACKGROUND: Our objective was to analyze the evolution of kidney damage over time in small children with urinary tract infection (UTI) and factors associated with progression of renal damage. METHODS: From a cohort of 1003 children <2 years of age with first-time UTI, a retrospective analysis of 103 children was done. Children were selected because of renal damage at index (99m)Tc-dimercaptosuccinic acid (DMSA) scintigraphy at least 3 months after UTI, and a late DMSA scan was performed after at least 2 years...
July 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28666918/urinary-tract-infection-after-retrograde-urethrogram-in-children-a-multicenter-study
#8
Neha R Malhotra, Jared R Green, Cynthia K Rigsby, Jane L Holl, Earl Y Cheng, Emilie K Johnson
INTRODUCTION: The risk of post-procedural urinary tract infection (ppUTI) after retrograde urethrogram (RUG) has not been well quantified. Prophylactic antibiotics may reduce the risk, but must be weighed against the risks of antibiotic resistance. Prior research has shown that this risk is variable after voiding cystourethrogram (0-42% reported ppUTI rate) and appears to be low after urodynamics (0-4.8%) but this risk has not been well documented for patients undergoing RUG. OBJECTIVE: We aimed to (1) describe the rate of ppUTI after RUG, and (2) examine factors associated with use of antibiotics at the time of RUG...
June 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28638940/laparoscopic-vesico-ureteral-reimplantation-with-lich-gregoir-approach-in-children-medium-term-results-of-159-renal-units-in-117-children
#9
Victor Soulier, Aure Lien Scalabre, Manuel Lopez, Chi-Ying Li, Sodara Thach, Sophie Vermersch, Franc Ois Varlet
PURPOSE: Vesico-ureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Surgery is an important part of its management. Laparoscopic ureteric reimplantation using the Lich-Gregoir technique is an option for VUR. The aim of this study is to assess short- and medium-term outcomes of this approach. MATERIALS AND METHODS: This is a retrospective study including all children with VUR treated by laparoscopic extravesical ureteral reimplantation with the Lich-Gregoir technique in University Hospital of Saint-Etienne from August 2007 to May 2016...
June 21, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28637056/-urosepsis-in-children
#10
Josef Oswald
Urinary tract infections (UTI) are the most common infectious diseases in children. Urosepsis in childhood, though rare, is the most complicated possible variant. In newborns and infants, unspecific symptoms are a significant barrier to a fast and reliable diagnosis, which is crucial to successful treatment. In addition to urine and laboratory tests as well as non-invasive examinations (ultrasound), there may be an indication for invasive examinations of the kidneys (DMSA scans) in cases of a severe infection...
June 21, 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28630017/vesicoureteral-reflux-is-a-phenotype-not-a-disease-a-population-centered-approach-to-pediatric-urinary-tract-infection
#11
REVIEW
Jathin Bandari, Steven G Docimo
We performed a review of the recent literature concerning urinary tract infection (UTI) evaluation and management. In modeling options for management, one overriding conclusion became apparent: in most affected children, the presence of vesicoureteral reflux (VUR) is inconsequential since it has no bearing on optimal management or outcome. In fact, knowing that a child does not have reflux might bias the provider to withhold potentially helpful therapeutic modalities to decrease UTI morbidity, such as antibiotic prophylaxis...
May 22, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28612056/critical-appraisal-of-the-top-down-approach-for-vesicoureteral-reflux
#12
REVIEW
Ahmed Abdelhalim, Antoine E Khoury
Vesicoureteral reflux (VUR) has been linked to recurrent urinary tract infections (UTIs), renal scarring, hypertension, renal insufficiency and end-stage kidney disease. Different imaging strategies have been proposed to approach children presenting with UTI to sort out patients with significant VUR while minimizing patient morbidity, radiation exposure and financial burden. None of these imaging strategies is universally accepted. The"top-down approach" (TDA) aims at restricting the number of voiding cystourethrograms (VCUGs) and its associated morbidity while identifying patients with clinically-significant reflux...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28595971/bladder-debris-on-renal-and-bladder-ultrasound-a-significant-predictor-of-positive-urine-culture
#13
Joseph W McQuaid, Michael P Kurtz, Tanya Logvinenko, Caleb P Nelson
BACKGROUND: Renal and bladder ultrasound (RBUS) is recommended in evaluation of children after an initial, febrile urinary tract infection. Although it is not uncommon to observe debris within the bladder lumen on sonography, the significance of this finding is uncertain. Debris may be interpreted as an indication of ongoing infection, but there have been no studies to date investigating the association of bladder debris with a positive culture. OBJECTIVE: The aim of this study was to evaluate the association of bladder debris noted at the time of RBUS with positive urine culture results obtained from a catheterized specimen, among patients undergoing RBUS and voiding cystourethrogram (VCUG) on the same day...
May 26, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28592391/long-term-fate-of-the-upper-tracts-following-complete-primary-repair-of-bladder-exstrophy
#14
Jonathan S Ellison, Jennifer Ahn, Margarett Shnorhavorian, Richard Grady, Paul A Merguerian
INTRODUCTION: Complete primary repair of bladder exstrophy (CPRE) is widely used for classic bladder exstrophy (CBE) closure. Long-term renal function with or without dilation in these patients is poorly characterized and may be impacted by bladder storage parameters or recurrent urinary tract infections (UTIs). OBJECTIVE: We sought to assess our long-term experience with CPRE and investigate factors that may influence upper-tract deterioration. STUDY DESIGN: A retrospective review of patients at our institution with CBE undergoing CPRE from 1990 to 2015 was performed...
May 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28587907/-a-family-history-of-renal-lithiasis-in-children-diagnosed-of-urinary-tract-infection-by-escherichia-coli
#15
Víctor García Nieto, Jorge Sotoca Fernández, Monica O'Hagan, Pedro Arango Sancho, Maria Isabel Luis Yanes
INTRODUCTION: Urinary tract infections (UTI) caused by Escherichia coli (E. coli) are common in patients with idiopathic hypercalciuria. As both UTI and hypercalciuria (prelithiasis) have a genetic basis, we wanted to know whether the family history of urolithiasis is more common in children with UTIs caused by E. coli. Secondarily, we wondered if the renal scars are more common in children with prelithiasis. MATERIAL AND METHODS: Ambispective study with collected data from 104 patients (40 male, 64 female) followed after having been diagnosed of UTI by E...
June 3, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28583570/clinical-outcomes-in-pediatric-renal-transplant-recipients-who-received-steroid-based-immunosuppressive-regimen
#16
S Chantarogh, K Tangnararatchakit, W Tirapanich, W Viseshsindh, P Saisawat, K Pirojsakul
BACKGROUND: Although the clinical outcomes of pediatric renal transplantation (RT) in developed countries have improved significantly, the data on clinical outcomes in developing countries are wildly different. METHODS: Children and adolescents who had undergone RT at Ramathibodi Hospital between March 2001 and August 2014 were included. RESULTS: Patients were divided into 2 groups: living related donor (LRD) group (n = 13) and deceased donor (DD) group (n = 30)...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28579135/urinary-tract-infection-after-voiding-cystourethrogram
#17
E K Johnson, N R Malhotra, R Shannon, D L Jacobson, J Green, C K Rigsby, J L Holl, E Y Cheng
BACKGROUND: Reported rates of post-procedural urinary tract infection (ppUTI) after voiding cystourethrogram (VCUG) are highly variable (0-42%). OBJECTIVE: This study aimed to determine the risk of ppUTI after cystogram, and evaluate predictors of ppUTI. STUDY DESIGN: A retrospective cohort study of children undergoing VCUG or radionuclide cystogram (henceforth 'cystogram') was conducted. Children with neurogenic bladder who underwent cystogram in the operating room and without follow-up at the study institution were excluded...
May 25, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28579134/the-impact-of-obesity-on-pediatric-inpatients-with-urinary-tract-infections-in-the-united-states
#18
Yusuke Okubo, Atsuhiko Handa
INTRODUCTION: Urinary tract infections (UTI) are common infectious disorders, and obesity is an increasing public health problem worldwide. Several studies have suggested that childhood obesity may be associated with the development of UTI. However, the potential effects of obesity on the clinical outcomes of UTI in children remain unknown. MATERIALS AND METHODS: Hospital discharge records for patients aged 18 years or younger with a diagnosis of UTI were extracted from the 2012 Kids' Inpatient Database...
May 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28557737/antibiotic-prophylaxis-for-urinary-tract-infection-related-renal-scarring-a-systematic-review
#19
REVIEW
Ian K Hewitt, Marco Pennesi, William Morello, Luca Ronfani, Giovanni Montini
CONTEXT: Acute pyelonephritis may result in renal scarring. Recent prospective studies have shown a small benefit of antibiotic prophylaxis in preventing symptomatic and febrile urinary tract infections (UTIs), while being underpowered to detect any influence in prevention of renal damage. OBJECTIVES: Review of the literature and a meta-analysis to evaluate the effect of antibiotic prophylaxis on UTI-related renal scarring. DATA SOURCES: Medline, Embase, and Cochrane Controlled Trials Register electronic databases were searched for studies published in any language and bibliographies of identified prospective randomized controlled trials (RCTs) performed and published between 1946 and August 2016...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28555450/usefulness-of-parametric-renal-clearance-images-in-the-assessment-of-basic-risk-factors-for-renalnal-clearance-images-in-the-assessment-of-basic-risk-factors-for-renal-scarring-in-children-with-recurrent-urinary-tract-infections
#20
Ewa Pietrzak-Stelasiak, Małgorzata Bieńkiewicz, Wojciech Woźnicki, Krystyna Bubińska, Magdalena Kowalewska-Pietrzak, Anna Płachcińska, Jacek Kuśmierek
BACKGROUND: Clinically confirmed incidents of acute pyelonephritis (APN) following recurrent infections of urinary tract (UTI) form basic risk factors for renal scarring in children. Vesico-uretheral reflux (VUR) of higher grade is additional risk factor for this scarring. Opinions on diagnostic value of summed sequential images of renal uptake phase (SUM) of dynamic renal scintigraphy in detection of renal scars are diverse. However, several publications point to higher diagnostic efficacy of clearance parametric images (PAR) generated from this study...
2017: Nuclear Medicine Review. Central & Eastern Europe
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