Characteristics of First Urinary Tract Infection With Fever in Children: A Prospective Clinical and Imaging Study
The Pediatric Infectious Disease Journal, 04/18/2011
Ismaili Khalid et al. - Girls represent 63% of cases with first urinary tract infection (UTI). For 91% of UTIs, Escherichia coli is held responsible with a high rate of resistance to ampicillin and trimethoprim/sulfamethoxazole. US is an excellent screening tool that allows avoidance of unjustified voiding cystourethrography studies.Methods
- The authors prospectively followed (median, 20 months) 209 children treated for first febrile UTI.
- Renal ultrasound (US) and voiding cystourethrography examinations were performed in all patients.
- Among the children, 63% were females and 37% were males, and 75% of them had their first UTI before the age of 2 years.
- The most common causative agent was Escherichia coli (91% of cases) with high rate resistance to ampicillin (58%) and trimethoprim/sulfamethoxazole (38%).
- Of these children, 25% had evidence of VUR (15 boys and 38 girls). VUR was of low grade in 85% of cases.
- The overall performance of renal US as a diagnostic test to detect significant uropathies excluding low-grade vesicoureteral reflux (VUR) was excellent; the sensitivity attained 97% and the specificity 94%.