AIM: In 2009, the Italian society for paediatric nephrology suggested the need for cystography, following a first febrile urinary tract infection (UTI), only in children at high risk for dilating vesicoureteral reflux or in the event of a second infection. The aim of this study was to evaluate the adequacy of the risk factors proposed by the Italian guidelines. METHODS: Children aged 2-36 months, managed by 10 Italian hospitals between 2009 and 2013, with a first febrile UTI were retrospectively evaluated. RESULTS: Four hundred and fourteen children were included: 51% female, mean age eight months. Escherichia coli was responsible of 84% UTIs. 269 children (65%) presented at least one risk factor, thus were further investigated: 44% had a reflux. The presence of a pathogen other than E. coli significantly predicted high-grade reflux, both in the univariate (Odd Ratio 2.52, 95% Confidence Interval 1.32-4.81, p < 0.005) and multivariate analysis (OR 2.74, 95% CI: 1.39-5.41, p: 0.003). 26/145 children (18%) with no risk factors experienced a second UTI, which prompted the execution of cystography, showing a dilating reflux in 11. CONCLUSION: Among the risk factors proposed by the Italian guidelines, only the presence of a pathogen other than E. coli significantly predicted reflux. Cystography can be postponed in children with no risk factors.
First urinary tract infections in children : the role of the risk factors proposed by the Italian recommendations / I. Alberici, A. La Manna, M. Pennesi, M. Starc, F. Scozzola, G. Nicolini, A. Toffolo, G. Marra, R. Chimenz, F. Sica, S. Maringhini, L. Monasta, G. Montini. - In: ACTA PAEDIATRICA. - ISSN 0803-5253. - 108:3(2019 Mar), pp. 544-550.
|Titolo:||First urinary tract infections in children : the role of the risk factors proposed by the Italian recommendations|
MONTINI, GIOVANNI [Conceptualization] (Corresponding)
|Parole Chiave:||Guidelines; Urinary tract infection; Vesicoureteral reflux|
|Settore Scientifico Disciplinare:||Settore MED/38 - Pediatria Generale e Specialistica|
|Data di pubblicazione:||mar-2019|
|Data ahead of print / Data di stampa:||17-ago-2018|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1111/apa.14506|
|Appare nelle tipologie:||01 - Articolo su periodico|