PD37-10 THE TRUE INCIDENCE OF URINARY TRACT INFECTIONS AMONG INFANTS WITH ISOLATED HYDRONEPHROSIS

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD37-10 THE TRUE INCIDENCE OF URINARY TRACT INFECTIONS AMONG INFANTS WITH ISOLATED HYDRONEPHROSIS Margarita Chancy, Jin K Kim, Michael Chua, Joana Santos, Natasha Brownrigg, Juliane Richter, Tim Van Mieghem, Armando J Lorenzo, and Mandy Rickard Margarita ChancyMargarita Chancy More articles by this author , Jin K KimJin K Kim More articles by this author , Michael ChuaMichael Chua More articles by this author , Joana SantosJoana Santos More articles by this author , Natasha BrownriggNatasha Brownrigg More articles by this author , Juliane RichterJuliane Richter More articles by this author , Tim Van MieghemTim Van Mieghem More articles by this author , Armando J LorenzoArmando J Lorenzo More articles by this author , and Mandy RickardMandy Rickard More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003335.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The rate of UTI in healthy febrile infants is 7%. Isolated hydronephrosis (HN) refers to dilation of the renal pelvis and has been associated with an increased risk of UTI resulting in continuous antibiotic prophylaxis (CAP) use. Our goal was to determine the overall rate of UTI stratified by type, CAP, VUR. METHODS: A HN database from 2015-22 was examined. Included patients were less than 24 m at baseline with isolated HN, and those with other abnormalities were excluded. Captured variables included age, sex, circumcision status, HN severity and VUR. UTI was defined as fever with pyuria and positive culture from catheterized specimens. UTIs were categorized as index (pre-presentation), surveillance (while being followed), and post-procedural (associated with surgery/tests). RESULTS: A total of 689 patients were included. The median age at baseline was 2 m (0-24 m) and follow-up was 23 m (6-195). A total of 52% were prescribed CAP and received it for 6 m (0-53). The overall UTI rate was 9% which developed at 5 months (0-32 m) of age. UTIs were index in 32 (5%), surveillance in 11 (2%) and post-procedural in 20 (3%). After excluding procedural UTIs, the actual rate was 7%. Most patients were male (81%) and 62% were uncircumcised. Uncircumcised males comprised 77%, 64% and 63% of index, surveillance and post-procedural UTI respectively. 96% had isolated HN and 53% had high grade (SFU 3-4) 1% of had concomitant UPJ+UVJ obstruction and 3% were known to have VUR, however only 30% were investigated with VCUG. When comparing surveillance UTI to none, the only significant finding was more VUR in the surveillance group (18%) vs. 2% in the no infection group (p<0.01). UTI characteristics by category can be reviewed in Table 1. Comparisons between surveillance and no UTIs can be reviewed in Table 2. CONCLUSIONS: The overall incidence of UTI in children with isolated HN is low. We demonstrated that the rate of UTI is similar to the general population, generating controversy regarding the necessity of CAP. This presents an opportunity to limit exposure to antibiotics to children with isolated HN. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e991 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Margarita Chancy More articles by this author Jin K Kim More articles by this author Michael Chua More articles by this author Joana Santos More articles by this author Natasha Brownrigg More articles by this author Juliane Richter More articles by this author Tim Van Mieghem More articles by this author Armando J Lorenzo More articles by this author Mandy Rickard More articles by this author Expand All Advertisement PDF downloadLoading ...