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Infectious Disorders - Drug Targets

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ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

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Research Article

Urinary Tract Infection in Infants <1 Month of Age: Demographic, Clinical, and Microbiological Characteristics

Author(s): Armin Karamian, Roshanak Modiri, Hossein Hosseinirad and Majid Firouzi*

Volume 23, Issue 3, 2023

Published on: 09 January, 2023

Article ID: e161122210959 Pages: 5

DOI: 10.2174/1871526523666221116103202

Price: $65

Abstract

Background: This cross-sectional study was conducted on 232 infants aged <1 month with proven UTI admitted to three major teaching hospitals for the period 2010-2018 to assess clinical, demographic, and laboratory findings of urinary tract infection in this age group.

Methods: All information was extracted from the medical records. Urinary tract infection was defined as ≥ 50,000 colony-forming units per milliliter of a single uropathogen isolated from a catheterized or suprapubic aspiration or greater than 100,000 colony-forming units per milliliter from a midstream, clean-catch sample.

Results: The most common pathogen isolated was E. coli (78.4%), followed by Enterobacter and Klebsiella, accounting for 12.1 and 4.7% respectively. The main presenting clinical manifestation was jaundice, which was found in 54.7% of cases; it was followed by restlessness (45.6%) and fever (40%).

Conclusion: During infancy, the signs and symptoms of UTI are often nonspecific and although urine culture is a gold standard diagnostic tool specimen collection is challenging and urine contamination is common in children, therefore it makes the diagnosis difficult. UTI in infants may indicate underlying genitourinary abnormalities; therefore, appropriate diagnosis and immediate initiation of antibiotic therapy are crucial to decrease long-term complications like renal scarring. According to our study, the most common clinical features were jaundice, restlessness, and fever, therefore it is suggested that urine culture should be performed for all infants presenting with these signs and symptoms.

Graphical Abstract

[1]
Chesney RW, Carpenter MA, Moxey-Mims M, et al. Randomized intervention for children with vesicoureteral reflux (RIVUR): Background commentary of RIVUR investigators. Pediatrics 2008; S5: 233-9.
[2]
Keren R, Shaikh N, Pohl H, et al. Risk factors for recurrent urinary tract infection and renal scarring. Pediatrics 2015; 136(1): e13-21.
[http://dx.doi.org/10.1542/peds.2015-0409] [PMID: 26055855]
[3]
Millner R, Becknell B. Urinary tract infections. Pediatr Clin North Am 2019; 66(1): 1-13.
[http://dx.doi.org/10.1016/j.pcl.2018.08.002] [PMID: 30454735]
[4]
Song JY, Yoo S, Lim TJ, et al. Ampicillin-sulbactam monotherapy in infants with febrile urinary tract infections. Pediatrics 2021; 63(4): 430-5.
[http://dx.doi.org/10.1111/ped.14454]
[5]
Leung AKC, Wong AHC, Leung AAM, Hon KL. Urinary tract infection in children. Recent Pat Inflamm Allergy Drug Discov 2019; 13(1): 2-18.
[http://dx.doi.org/10.2174/1872213X13666181228154940] [PMID: 30592257]
[6]
Chang SL, Shortliffe LD. Pediatric urinary tract infections. Pediatr Clin North Am 2006; 53(3): 379-400. vi.
[http://dx.doi.org/10.1016/j.pcl.2006.02.011] [PMID: 16716786]
[7]
Simões e Silva AC, Oliveira EA. Update on the approach of urinary tract infection in childhood. J Pediatr 2015; 91(6): S2-S10.
[http://dx.doi.org/10.1016/j.jped.2015.05.003] [PMID: 26361319]
[8]
Arshad M, Seed PC. Urinary tract infections in the infant. Clin Perinatol 2015; 42(1): 17-28. vii.
[http://dx.doi.org/10.1016/j.clp.2014.10.003] [PMID: 25677994]
[9]
Clark CJ, Kennedy WA II, Shortliffe LD. Urinary tract infection in children: When to worry. Urol Clin North Am 2010; 37(2): 229-41.
[http://dx.doi.org/10.1016/j.ucl.2010.03.009] [PMID: 20569801]
[10]
Shaikh N, Hoberman A. Urinary tract infections in children: Epidemiology and risk factors. UpToDate 2022.
[11]
Schlager TA. Urinary tract infections in infants and children. Infect Dis Clin North Am 2003; 17(2): 353-65. ix.
[http://dx.doi.org/10.1016/S0891-5520(03)00009-6] [PMID: 12848474]
[12]
Hanna-Wakim RH, Ghanem ST, El Helou MW, et al. Epidemiology and characteristics of urinary tract infections in children and adolescents. Front Cell Infect Microbiol 2015; 5: 45.
[http://dx.doi.org/10.3389/fcimb.2015.00045] [PMID: 26075187]
[13]
Falup-Pecurariu O, Leibovitz E, Vorovenci C, et al. First UTI episode in life in infants <1 year of age: Epidemiologic, clinical, microbiologic and disease recurrence characteristics. Pediatr Neonatol 2020; 61(6): 613-9.
[http://dx.doi.org/10.1016/j.pedneo.2020.07.008] [PMID: 32819848]
[14]
Chen LJ, Chen PJ, Yang SF, Chen JY. Causative organisms and antimicrobial susceptibility in jaundiced infants with significant bacteriuria. J Chin Med Assoc 2022; 85(4): 514-8.
[http://dx.doi.org/10.1097/JCMA.0000000000000698] [PMID: 35120356]
[15]
Bell LE, Mattoo TK. Update on childhood urinary tract infection and vesicoureteral reflux. Semin Nephrol 2009; 29(4): 349-59.
[http://dx.doi.org/10.1016/j.semnephrol.2009.03.011] [PMID: 19615556]
[16]
Becknell B, Schober M, Korbel L, Spencer JD. The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections. Expert Rev Anti Infect Ther 2015; 13(1): 81-90.
[http://dx.doi.org/10.1586/14787210.2015.986097] [PMID: 25421102]
[17]
Zorc JJ, Kiddoo DA, Shaw KN. Diagnosis and management of pediatric urinary tract infections. Clin Microbiol Rev 2005; 18(2): 417-22.
[http://dx.doi.org/10.1128/CMR.18.2.417-422.2005] [PMID: 15831830]
[18]
Tola HH, Ranjbaran M, Omani-Samani R, Sadeghi M. Prevalence of UTI among Iranian infants with prolonged jaundice, and its main causes: A systematic review and meta-analysis study. J Pediatr Urol 2018; 14(2): 108-15.
[http://dx.doi.org/10.1016/j.jpurol.2018.01.004] [PMID: 29456119]
[19]
Geerlings SE. Clinical presentations and epidemiology of urinary tract infections Microbiol Spectr 2016; 4(5): 4.5.03.
[http://dx.doi.org/10.1128/microbiolspec.UTI-0002-2012] [PMID: 27780014]
[20]
Baz AMK, El-Agamy OAEF, Ibrahim AM. Incidence of urinary tract infection in neonates with significant indirect Hyperbilirubinemia of unknown etiology: Case-control study. Ital J Pediatr 2021; 47(1): 35.
[http://dx.doi.org/10.1186/s13052-021-00982-0] [PMID: 33596989]
[21]
Roberts KB. Urinary tract infection: Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 2011; 128(3): 595-610.
[http://dx.doi.org/10.1542/peds.2011-1330] [PMID: 21873693]
[22]
Ismaili K, Lolin K, Damry N, Alexander M, Lepage P, Hall M. Febrile urinary tract infections in 0- to 3-month-old infants: A prospective follow-up study. J Pediatr 2011; 158(1): 91-4.
[http://dx.doi.org/10.1016/j.jpeds.2010.06.053] [PMID: 20708748]
[23]
Sencan A, Carvas F, Hekimoglu IC, et al. Urinary tract infection and vesicoureteral reflux in children with mild antenatal hydronephrosis. J Pediatr Urol 2014; 10(6): 1008-13.
[http://dx.doi.org/10.1016/j.jpurol.2014.04.001] [PMID: 24863985]
[24]
Williams GJ, Hodson EH, Isaacs D, Craig JC. Diagnosis and management of urinary tract infection in children. J Paediatr Child Health 2012; 48(4): 296-301.
[http://dx.doi.org/10.1111/j.1440-1754.2010.01925.x] [PMID: 21199053]
[25]
Yamasaki Y, Uemura O, Nagai T, et al. Pitfalls of diagnosing urinary tract infection in infants and young children. Pediatrics 2017; 59(7): 786-92.
[http://dx.doi.org/10.1111/ped.13292]
[26]
Riskin A, Toropine A, Bader D, Hemo M, Srugo I, Kugelman A. Is it justified to include urine cultures in early (< 72 hours) neonatal sepsis evaluations of term and late preterm infants? Am J Perinatol 2013; 30(6): 499-504.
[PMID: 23147081]
[27]
Samayam P, Ravi Chander B. Study of urinary tract infection and bacteriuria in neonatal sepsis. Indian J Pediatr 2012; 79(8): 1033-6.
[http://dx.doi.org/10.1007/s12098-012-0727-7] [PMID: 22421936]

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