Incidence of Acute Pyelonephritis in Hospitalized Children under 5 Years Old with Positive Urine Culture

Alexandra Castaño González,Juan Gabriel Ruiz Peláez

doi:10.11144/javeriana.umed59-4.piel

Abstract

Introduction: Urinary tract infection is a major cause of child morbidity. The diagnosis of acute pyelonephritis is important to decide the treatment. Methods: Retrospective observational study. We collected information of urinalysis, urine Gram and urine culture of hospitalized children between 3 months and 5 years old, with suspected urinary tract infection between January 2008 and December 2010. In patients with positive urine culture, the results of renal scintigraphy (Gamma scan) were evaluated to estimate the incidence of acute pyelonephritis. Results: We identified 1,463 medical records. Urinary culture was obtained in 237 patients, of whom 54.4% were positive. Renal scintigraphy was obtained in 93 of these patients and 59.1% were positive. Conclusions: The incidence of acute pyelonephritis in patients with confirmed urinary tract infection was 59.1%.

Highlights

Urinary tract infection is a major cause of child morbidity
The incidence of secondary renal scars increases with each new episode of acute pyelonephritis, as well as when there is a delay in the diagnosis and initiation of the appropriate antibiotic therapy [5]
Urinalysis was performed in 67.9% (n = 993) of the patients and a result suggestive of Urinary tract infection (UTI) was obtained in 13.6% (n = 136) of the children

Summary

Introduction

Urinary tract infection is a major cause of child morbidity. The diagnosis of acute pyelonephritis is important to decide the treatment. Urinary tract infection (UTI) is an important cause of child morbidity [1], and in many cases it is an indicator of anatomical urological alterations and a risk factor for the development of renal scars, arterial hypertension and chronic renal failure [2]. Infants have a higher risk of acute and chronic complications secondary to UTI, due to the higher incidence of renal scars in this population [4] and the difficulties in diagnosis, taking into account its nonspecific symptoms; in infants, fever, irritability and vomiting are manifestations of both urinary infections and many self-limiting viral diseases [4]. The incidence of secondary renal scars increases with each new episode of acute pyelonephritis, as well as when there is a delay in the diagnosis and initiation of the appropriate antibiotic therapy [5]. Renal scars increase the risk of recurrent episodes of acute pyelonephritis, impaired glomerular function, hypertension, and pregnancy-induced hypertension [3]

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Results

Discussion

Conclusion