391 results match your criteria Pediatrics Urinary Tract Infections and Pyelonephritis


Acute pyelonephritis diagnosis in children with urinary tract infections.

Authors:
Chi-Hui Cheng

Pediatr Neonatol 2022 Jun 9. Epub 2022 Jun 9.

Division of Pediatric Nephrology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department Pediatrics, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address:

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Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis.

BMJ Open 2022 04 27;12(4):e057736. Epub 2022 Apr 27.

Department 2 of Nephrology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Objective: To explore the current Chinese and English guidelines of urinary tract infection (UTI) in children and provide a summary of the recommendations of the guidelines.

Methods: An electronic search was conducted on databases, including Pubmed, SinoMed, Wangfang Data, CHKD,VIP, NICE, WHO, GIN and Medliveto retrieve data of the clinical practice guidelines on UTI from the establishment of the database to June 2020. Four assessors assessed the quality of guidelines using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and evaluated the specific recommendations in guidelines. Read More

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The role of renal contour change in the diagnosis of cortical scarring after urinary tract infection.

Am J Nucl Med Mol Imaging 2022 15;12(1):41-43. Epub 2022 Feb 15.

University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Division of General Academic Pediatrics Pittsburgh, PA 15224, USA.

Urinary tract infections in children can lead to permanent renal scarring in approximately 15% of cases. Technetium-99m (Tc)-dimercaptosuccinic acid (DMSA) scintigraphy is the gold standard for identifying renal scarring. Using data and scans from children enrolled at our center in a 2-year prospective clinical trial (RIVUR study), we included children with radiologically confirmed pyelonephritis who exhibited renal scarring on their 1 and/or 2-year follow-up scans and asked 3 blinded pediatric nuclear medicine physicians to reexamine the renal contours in these scans. Read More

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February 2022

The value of interleukin levels in the diagnosis of febrile urinary tract infections in children and adolescents; a systematic review and meta-analysis.

J Pediatr Urol 2022 Apr 23;18(2):211-223. Epub 2022 Jan 23.

Pediatrics Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction: In recent years, researchers have been looking for tools and biomarkers to identify urinary tract infections (UTI) in children. Since there exists no systematic reviews and meta-analyses on the matter, the present study intends to determine the diagnostic value of serum and urinary levels of interleukins (IL) in the diagnosis of febrile UTI in children and adolescents.

Methods: Medline, Embase, Scopus, and Web of Science were searched until the end of 2020, using keywords related to UTI and serum and urinary ILs. Read More

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Facklamia hominis pyelonephritis in a pediatric patient: first case report and review of the literature.

Ann Clin Microbiol Antimicrob 2022 Feb 12;21(1). Epub 2022 Feb 12.

Department of Pediatrics / Infectious Diseases Service, Hospital Universitario "Dr. José Eleuterio González" Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC, 64460, Monterrey, Mexico.

Background: Pyelonephritis is one of the most serious bacterial illnesses during childhood. Gram-negative organisms account for up to 90% of the cases. Gram-positive bacteria are uncommon causes of urinary tract infections, and only a few cases caused by Facklamia hominis have been reported in the literature. Read More

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February 2022

Emphysematous cystitis with bilateral pyelonephritis in a pediatric patient with COVID-19.

BMJ Case Rep 2022 Feb 3;15(2). Epub 2022 Feb 3.

Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA.

A 15-year-old female adolescent with a medical history of recurrent urinary tract infections and grade 1 left-sided vesicoureteral reflux presented to the emergency room with abdominal and back pain. Labs revealed a haemoglobin A1c (HbA1c) of 9.1% and a random blood glucose of 200 mg/dL, consistent with new-onset diabetes mellitus. Read More

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February 2022

Urinary tract infections decreased in Finnish children during the COVID-19 pandemic.

Eur J Pediatr 2022 May 31;181(5):1979-1984. Epub 2022 Jan 31.

Institute of Clinical Medicine, Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.

Social restrictions reduced the rates of respiratory infections in 2020, but studies on the rates of urinary tract infections (UTIs) during lockdown have had conflicting results. This study aimed to report UTI incidence during the first and second waves of COVID-19 pandemic in Finland. We conducted a retrospective register-based cohort study. Read More

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Dexamethasone to prevent kidney scarring in acute pyelonephritis: a randomized clinical trial.

Pediatr Nephrol 2022 Jan 18. Epub 2022 Jan 18.

Pediatrics Unit, Hospital Universitari Sant Joan de Reus, Reus, Spain.

Background: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood and is associated with long-term complications. We aimed to assess the effect of adjuvant dexamethasone treatment on reducing kidney scarring after acute pyelonephritis (APN) in children.

Methods: Multicenter, prospective, double-blind, placebo-controlled, randomized clinical trial (RCT) where children from 1 month to 14 years of age with proven APN were randomly assigned to receive a 3-day course of either an intravenous corticosteroid (dexamethasone 0. Read More

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January 2022

Neonatal Urinary Tract Infection and Renal Nodular Lesion: A Rare Case of Xanthogranulomatous Pyelonephritis.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096211066295

Unit of Pediatric Nephrology, Department of Pediatrics, Centro Hospitalar Universitário São João, Porto, Portugal.

Xanthogranulomatous pyelonephritis (XPN) is an uncommon variant of chronic pyelonephritis with a poorly understood pathogenesis and a challenging diagnosis. It is rare in pediatric patients, particularly in the neonatal period. We report the case of an 18-day-old female neonate admitted to the emergency room due to macroscopic hematuria and poor feeding. Read More

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January 2022

Differential Serum and Urine CRP, IP-10, and TRAIL Levels in Pediatric Urinary Tract Infection.

Front Pediatr 2021 13;9:771118. Epub 2021 Dec 13.

Adelson School of Medicine, Ariel University, Ariel, Israel.

It is estimated that clinical evaluation and urinalysis are unable to diagnose >10% of urinary tract infections (UTI) in young children. TNF-related apoptosis induced ligand (TRAIL), interferon gamma induced protein-10 (IP-10), and C-reactive protein (CRP) exhibit differential expression in the blood in response to bacterial vs. viral infection. Read More

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December 2021

Risk Factors for the Development of Febrile Recurrences in Children with a History of Urinary Tract Infection.

J Pediatr 2022 04 23;243:152-157. Epub 2021 Dec 23.

Division of General Academic Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA. Electronic address:

Objective: To identify risk factors for febrile recurrence of urinary tract infections (UTIs) in children with a history of UTI.

Study Design: We included 500 children aged 2-72 months with a history of UTI who were followed prospectively for approximately 2 years in the context of 2 previously conducted studies (Randomized Intervention for Children with Vesicoureteral Reflux and Careful Urinary Tract Infection Evaluation). We identified significant risk factors for febrile recurrences among children not receiving antimicrobial prophylaxis using univariate and multivariate logistic regression. Read More

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Ribonuclease 7 polymorphism rs1263872 reduces antimicrobial activity and associates with pediatric urinary tract infections.

J Clin Invest 2021 11;131(22)

Kidney and Urinary Tract Center, Abigail Wexner Research Institute at Nationwide Children's, Columbus, Ohio, USA.

Ribonuclease 7 (RNase 7) is an antimicrobial peptide that prevents urinary tract infections (UTI); however, it is yet unknown how RNASE7 genetic variations affect its antimicrobial activity and its mitigation of UTI risk. This study determined whether the RNASE7 SNP rs1263872 is more prevalent in children with UTI and defined how rs1263872 affects RNase 7's antimicrobial activity against uropathogenic E. coli (UPEC). Read More

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November 2021

Diffusion tensor imaging based multiparametric characterization of renal lesions in infants with urinary tract infections: an explorative study.

BMC Pediatr 2021 10 8;21(1):440. Epub 2021 Oct 8.

Department of Radiation Physics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Background: Conventional diffusion weighted imaging (DWI) is a promising non-invasive tool in the evaluation of infants with symptomatic urinary tract infections (UTI). The use of multiparametric diffusion tensor imaging (DTI) provides further information on renal pathology by reflecting renal microstructure. However, its potential to characterize and distinguish between renal lesions, such as acute pyelonephritic lesions, permanent renal damages or dysplastic changes has not been shown. Read More

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October 2021

Diagnostic value of biomarkers for paediatric urinary tract infections in primary care: systematic review and meta-analysis.

BMC Fam Pract 2021 09 27;22(1):193. Epub 2021 Sep 27.

EPI-Centre, Academic Centre for General Practice, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.

Background: Accurate diagnosis of urinary tract infection is essential as children left untreated may suffer permanent renal injury.

Aim: To compare the diagnostic values of biomarkers or clinical prediction rules for urinary tract infections in children presenting to ambulatory care.

Design And Setting: Systematic review and meta-analysis of ambulatory care studies. Read More

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September 2021

Do Various Treatment Modalities of Vesicoureteral Reflux Have Any Adverse Effects in Pediatric Patients? A Meta-Analysis.

Urol Int 2021 23;105(11-12):1002-1010. Epub 2021 Sep 23.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Purpose: Vesicoureteral reflux (VUR) is a risk factor for various renal problems like recurrent urinary tract infections (UTIs), pyelonephritis, renal scarring, hypertension, and other renal parenchymal defects. The interventions followed by pediatricians include low-dose antibiotic treatment, surgical correction, and endoscopy. This meta-analysis aimed to assess the advantages and drawbacks of various primary VUR treatment options. Read More

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February 2022

Quick-Wee versus bladder stimulation to collect midstream urine from precontinent infants under 1 year of age: a study protocol for a randomised controlled trial (ES.Stimquick.U).

BMJ Open 2021 09 16;11(9):e046324. Epub 2021 Sep 16.

Service des Urgences Pédiatriques, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, France.

Introduction: Urinary tract infections occur in around 1%-4% of boys and 3%-8% of girls under 2 years old. Diagnosis is difficult because of non-specific symptoms and the risk of urine analysis contamination depending on the sampling method used for precontinent infants. The American Academy of Pediatrics recommend transurethral catheterisation and suprapubic aspiration because of a low contamination rate but these techniques are invasive. Read More

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September 2021

Protective Effects of Omega-3 Fatty Acids Supplementation Against Renal Parenchymal Scarring in Children with Acute Pyelonephritis: Results of a Pilot Clinical Trial.

Curr Pediatr Rev 2022 ;18(1):72-81

Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

Aim: This trial aimed to determine if supplementation with omega-3 fatty acids as an adjunct therapy to antibiotic treatment can have protective effects against renal scar formation after acute pyelonephritis (APN) in pediatric patients.

Background: Current evidence points out that besides antibiotic treatment, early administration of antioxidant and anti-inflammatory compounds may be effective in reducing the occurrence of renal damage following APN in children.

Objective: The main endpoint of the trial was the comparison of the development of renal scarring formation after APN in an omega-3 fatty acids-treated group and in a control-treated group. Read More

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Asian guidelines for urinary tract infection in children.

J Infect Chemother 2021 Nov 11;27(11):1543-1554. Epub 2021 Aug 11.

Department of Urology, Uijeongbu ST. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea.

The followings are the level of evidence (LE) and grade of recommendation (GR) on pediatric UTI in Asia. Classification according to the sites of infection (lower versus upper tract), the number of episode (first versus recurrent), the severity (simple versus severe), or the existence of complicating factor (uncomplicated versus complicated) is useful to differentiate children with UTI whether they are at risk of renal damage or not (LE: 2, GR: B). Diagnosis of UTI requires both urinalysis that suggests infection and positive urine culture (LE:3, GR B). Read More

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November 2021

A mouse model displays host and bacterial strain differences in Aerococcus urinae urinary tract infection.

Biol Open 2021 08 13;10(8). Epub 2021 Aug 13.

Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA.

In recent years, the clinical significance of Aerococcus urinae has been increasingly recognized. A. urinae has been implicated in cases of urinary tract infection (UTI; acute cystitis and pyelonephritis) in both male and female patients, ranging from children to older adults. Read More

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Molecular determinants of disease severity in urinary tract infection.

Nat Rev Urol 2021 08 15;18(8):468-486. Epub 2021 Jun 15.

Department of Microbiology, Immunology and Glycobiology, Institute of Laboratory Medicine, Lund University, Lund, Sweden.

The most common and lethal bacterial pathogens have co-evolved with the host. Pathogens are the aggressors, and the host immune system is responsible for the defence. However, immune responses can also become destructive, and excessive innate immune activation is a major cause of infection-associated morbidity, exemplified by symptomatic urinary tract infections (UTIs), which are caused, in part, by excessive innate immune activation. Read More

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Serum Interleukin-6 and Interleukin-8 are Sensitive Markers for Early Detection of Pyelonephritis and Its Prevention to Progression to Chronic Kidney Disease.

Authors:
Mojgan Mazaheri

Int J Prev Med 2021 19;12. Epub 2021 Jan 19.

Department of Pediatrics, Section of Nephrology, Semnan University of Medical Sciences, Semnan, Iran.

Background: Pyelonephritis is the most common bacterial infection in children that can cause renal failure if not diagnosed or treated early. We used serum biomarker interleukins (IL-6 and IL-8) and then confirmed the results by the findings dimercaptosuccinic acid (DMSA) scan to distinguish upper-tract infection from lower-tract infection.

Methods: Serum IL-6 and IL-8 were measured in 57 children with newly diagnosed untreated urinary tract infection (UTI) documented by a positive urine culture. Read More

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January 2021

Oral steroids for reducing kidney scarring in young children with febrile urinary tract infections: the contribution of Bayesian analysis to a randomized trial not reaching its intended sample size.

Pediatr Nephrol 2021 11 25;36(11):3681-3692. Epub 2021 May 25.

Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, Milano, Italy.

Background: This study aimed to evaluate the effect of oral dexamethasone in reducing kidney scars in infants with a first febrile urinary tract infection (UTI).

Methods: Children aged between 2 and 24 months with their first presumed UTI, at high risk for kidney scarring based on procalcitonin levels (≥1 ng/mL), were randomly assigned to receive dexamethasone in addition to routine care or routine care only. Kidney scars were identified by kidney scan at 6 months after initial UTI. Read More

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November 2021

Transient Pseudohypoaldosteronism Secondary to Group B Streptococcus Pyelonephritis.

Cureus 2021 May 17;13(5):e15071. Epub 2021 May 17.

Pediatrics, Children Center, Matsudo City General Hospital, Matsudo, JPN.

Secondary pseudohypoaldosteronism is a condition characterized by aldosterone resistance in renal tubules. It is highly associated with urinary tract infection and urinary tract malformations. Only a few cases of pseudohypoaldosteronism secondary to group B pyelonephritis have been reported to date. Read More

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Risk of antibiotic treatment failure in premenopausal women with uncomplicated urinary tract infection.

Pharmacoepidemiol Drug Saf 2021 10 13;30(10):1360-1370. Epub 2021 Apr 13.

Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA.

Purpose: Acute uncomplicated urinary tract infections (UTIs) are among the most common indications for antibiotic prescriptions in otherwise healthy women. We compared the risk of treatment failure of antibiotic regimens for outpatient treatment of UTI in real-world practice.

Methods: We identified non-pregnant, premenopausal women diagnosed with uncomplicated, lower tract UTI and prescribed an oral antibiotic with activity against common uropathogens. Read More

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October 2021

Risk factors for kidney scarring and vesicoureteral reflux in 421 children after their first acute pyelonephritis, and appraisal of international guidelines.

Pediatr Nephrol 2021 09 23;36(9):2777-2787. Epub 2021 Mar 23.

Department of Pediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.

Background: Acute pyelonephritis (AP) is a common bacterial infection in childhood. Follow-up guidelines on these children are controversial. This study aimed to identify risk factors for kidney scarring and vesicoureteral reflux (VUR). Read More

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September 2021

Urinary vanin-1 for predicting acute pyelonephritis in young children with urinary tract infection: a pilot study.

Biomarkers 2021 Jun 26;26(4):318-324. Epub 2021 Mar 26.

Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland.

Background: Vanin-1, an epithelial glycosylphosphatidylolinositol (GPI)-anchored pantetheinase, is a valuable marker of renal injury.

Purpose: The aim of this study was to assess the predictive value of vanin-1 in acute pyelonephritis (APN) in comparison to the conventional serum inflammatory markers in children aged 1-24 months with the first episode of urinary tract infection (UTI).

Material And Methods: Urinary vanin-1, vanin-1/Cr ratio, WBC, CRP, PCT were analysed in 58 children with febrile UTI and in 18 children with non-febrile UTI. Read More

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Adjuvant corticosteroids for prevention of kidney scarring in children with acute pyelonephritis: a systematic review and meta-analysis.

Arch Dis Child 2021 11 25;106(11):1081-1086. Epub 2021 Feb 25.

Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Background: Acute pyelonephritis in children may result in permanent kidney scarring that is primarily caused by inflammation during acute infection. Antibiotic therapy alone is not enough to significantly reduce kidney scarring, and adjuvant corticosteroid therapy has shown a significant reduction in inflammatory cytokines in urine prompting its evaluation in randomised controlled trials. A few clinical trials showed a trend towards a reduction in renal scarring but did not have an adequate sample size to show a significant effect. Read More

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November 2021

Clinical manifestations, laboratory markers, and renal ultrasonographic examinations in 1-month to 12-year-old Iranian children with pyelonephritis: a six-year cross-sectional retrospective study.

BMC Infect Dis 2021 Feb 18;21(1):189. Epub 2021 Feb 18.

Department of Pediatric Nephrology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Upper urinary tract infection (UTI) or pyelonephritis may increase the pathogenesis rate and risk of severe complications in children due to kidney atrophy.

Objective: A set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to achieve the early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics.

Methods: A cross-sectional study with 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012-2018 was conducted. Read More

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February 2021

Contemporary Management of Urinary Tract Infection in Children.

Pediatrics 2021 02;147(2)

Department of Urology, Boston Children's Hospital and Department of Surgery, Harvard Medical School, Harvard University, Boston, Massachusetts.

Urinary tract infection (UTI) is common in children, and girls are at a significantly higher risk, as compared to boys, except in early infancy. Most cases are caused by Collection of an uncontaminated urine specimen is essential for accurate diagnosis. Oral antibiotic therapy for 7 to 10 days is adequate for uncomplicated cases that respond well to the treatment. Read More

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February 2021

Sex Differences in Population Dynamics during Formation of Kidney Bacterial Communities by Uropathogenic Escherichia coli.

Infect Immun 2021 03 17;89(4). Epub 2021 Mar 17.

Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA

Uropathogenic (UPEC), the primary etiologic agent of urinary tract infections (UTIs), encounters a restrictive population bottleneck within the female mammalian bladder. Its genetic diversity is restricted during establishment of cystitis because successful UPEC must invade superficial bladder epithelial cells prior to forming clonal intracellular bacterial communities (IBCs). In this study, we aimed to understand UPEC population dynamics during ascending pyelonephritis, namely, formation of kidney bacterial communities (KBCs) in the renal tubular lumen and nucleation of renal abscesses. Read More

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