Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study
Objectives To assess the association of clinical factors and investigation results (blood and urine) with imaging abnormalities (ultrasound of the kidneys, ureters and bladder; dimercaptosuccinic acid scan; and/or micturating cystourethrogram) and recurrent urinary tract infections (UTIs) in infants...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/7/1/e001687.full |
| _version_ | 1797368356775395328 |
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| author | Esther Huimin Leow Celeste Jia Ying Yap Sing Ming Chao Indra Ganesan Yong Hong Ng Siew Le Chong |
| author_facet | Esther Huimin Leow Celeste Jia Ying Yap Sing Ming Chao Indra Ganesan Yong Hong Ng Siew Le Chong |
| author_sort | Esther Huimin Leow |
| collection | DOAJ |
| description | Objectives To assess the association of clinical factors and investigation results (blood and urine) with imaging abnormalities (ultrasound of the kidneys, ureters and bladder; dimercaptosuccinic acid scan; and/or micturating cystourethrogram) and recurrent urinary tract infections (UTIs) in infants ≤3 months old presenting with their first febrile UTI.Methods We conducted a retrospective cohort study of infants ≤3 months old with first febrile UTI admitted from 2010 to 2016. Multivariable logistic regression model was used to analyse the association of imaging abnormalities and recurrent UTI with covariates selected a priori: age at presentation, maximum temperature, duration of illness at presentation, interval between start of antibiotics and fever resolution, C-reactive protein, total white cell count on the full blood count, bacteraemia, white cell count on the urinalysis and non-Escherichia coli growth in the urine culture (non-E. coli UTI).Results There were 190 infants but 12 did not undergo any imaging. Median age at presentation was 63 days (IQR 41–78). Twenty-four patients had imaging abnormalities. Non-E. coli UTI (adjusted OR (aOR) 5.01, 95% CI 1.65 to 15.24, p=0.004) was independently associated with imaging abnormalities, while bacteraemia (aOR 4.93, 95% CI 1.25 to 19.43, p=0.022) and non-E. coli UTI (aOR 5.06, 95% CI 1.90 to 13.48, p=0.001) were independently associated with recurrent UTI.Conclusion Non-E. coli UTI at the first febrile UTI in infants ≤3 months old may be useful in predicting imaging abnormalities while bacteraemia and non-E. coli UTI may be useful to predict recurrent UTI. |
| first_indexed | 2024-03-08T17:31:18Z |
| format | Article |
| id | doaj.art-f826f6974cfa4c689515c28f14f25b1b |
| institution | Directory Open Access Journal |
| issn | 2399-9772 |
| language | English |
| last_indexed | 2024-03-08T17:31:18Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj.art-f826f6974cfa4c689515c28f14f25b1b2024-01-02T15:50:07ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722023-12-017110.1136/bmjpo-2022-001687Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort studyEsther Huimin Leow0Celeste Jia Ying Yap1Sing Ming Chao2Indra Ganesan3Yong Hong Ng4Siew Le Chong5Paediatric Nephrology, KK Women`s and Children`s Hospital, SingaporePaediatric Nephrology, KK Women`s and Children`s Hospital, SingaporePaediatric Nephrology, KK Women`s and Children`s Hospital, SingaporePaediatric Nephrology, KK Women`s and Children`s Hospital, SingaporePaediatric Nephrology, KK Women`s and Children`s Hospital, SingaporePaediatric Nephrology, KK Women`s and Children`s Hospital, SingaporeObjectives To assess the association of clinical factors and investigation results (blood and urine) with imaging abnormalities (ultrasound of the kidneys, ureters and bladder; dimercaptosuccinic acid scan; and/or micturating cystourethrogram) and recurrent urinary tract infections (UTIs) in infants ≤3 months old presenting with their first febrile UTI.Methods We conducted a retrospective cohort study of infants ≤3 months old with first febrile UTI admitted from 2010 to 2016. Multivariable logistic regression model was used to analyse the association of imaging abnormalities and recurrent UTI with covariates selected a priori: age at presentation, maximum temperature, duration of illness at presentation, interval between start of antibiotics and fever resolution, C-reactive protein, total white cell count on the full blood count, bacteraemia, white cell count on the urinalysis and non-Escherichia coli growth in the urine culture (non-E. coli UTI).Results There were 190 infants but 12 did not undergo any imaging. Median age at presentation was 63 days (IQR 41–78). Twenty-four patients had imaging abnormalities. Non-E. coli UTI (adjusted OR (aOR) 5.01, 95% CI 1.65 to 15.24, p=0.004) was independently associated with imaging abnormalities, while bacteraemia (aOR 4.93, 95% CI 1.25 to 19.43, p=0.022) and non-E. coli UTI (aOR 5.06, 95% CI 1.90 to 13.48, p=0.001) were independently associated with recurrent UTI.Conclusion Non-E. coli UTI at the first febrile UTI in infants ≤3 months old may be useful in predicting imaging abnormalities while bacteraemia and non-E. coli UTI may be useful to predict recurrent UTI.https://bmjpaedsopen.bmj.com/content/7/1/e001687.full |
| spellingShingle | Esther Huimin Leow Celeste Jia Ying Yap Sing Ming Chao Indra Ganesan Yong Hong Ng Siew Le Chong Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study BMJ Paediatrics Open |
| title | Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study |
| title_full | Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study |
| title_fullStr | Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study |
| title_full_unstemmed | Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study |
| title_short | Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study |
| title_sort | risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old a retrospective cohort study |
| url | https://bmjpaedsopen.bmj.com/content/7/1/e001687.full |
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