367 results match your criteria Pediatrics Urinary Tract Infections and Pyelonephritis


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 May 25. 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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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 Mar 30. Epub 2021 Mar 30.

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

Pediatr Nephrol 2021 Mar 23. 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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Adjuvant corticosteroids for prevention of kidney scarring in children with acute pyelonephritis: a systematic review and meta-analysis.

Arch Dis Child 2021 Feb 25. 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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February 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 Mar 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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Impact of early-life weight status on urinary tract infections in children: a nationwide population-based study in Korea.

Epidemiol Health 2021 29;43:e2021005. Epub 2020 Dec 29.

Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.

Objectives: We aimed to evaluate the association between early-life weight status and urinary tract infection (UTI) risk in children.

Methods: A nationwide study was conducted using Korean National Health Screening (NHS) data and National Health Insurance Service data. A sample cohort was selected using data from the 2014 and 2015 NHS for infants and children (4-71 months) and followed up until the end of 2017. Read More

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Antibiotic prescribing for adult bacteriuria and pyuria in community hospital emergency departments.

Am J Emerg Med 2021 02 4;40:1-5. Epub 2020 Dec 4.

Infectious Diseases Telehealth Service, Intermountain Healthcare, Intermountain Medical Center, Murray, UT, USA; Division of Infectious Diseases and Epidemiology, Intermountain Healthcare, Intermountain Medical Center, Murray, UT, USA.

Objective: To describe emergency department (ED) antibiotic prescribing for urinary tract infections (UTIs) and asymptomatic bacteriuria (ASB) and to identify improvement opportunities.

Methods: Patients treated for UTI in 16 community hospital EDs were reviewed to identify prescribing that was unnecessary (any treatment for ASB, duration >7 days for cystitis or >14 days for pyelonephritis) or suboptimal [ineffective antibiotics (nitrofurantoin/fosfomycin) or duration <7 days for pyelonephritis]. Duration criteria were based on recommendations for complicated UTI since criteria for uncomplicated UTI were not reviewed. Read More

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February 2021

Serum and Urine Interleukin-6 and Interleukin-8 Levels Do Not Differentiate Acute Pyelonephritis from Lower Urinary Tract Infections in Children.

J Inflamm Res 2020 28;13:789-797. Epub 2020 Oct 28.

Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.

Background: Urinary tract infection (UTI) is common in pediatrics. Infection of the upper urinary tract may cause renal scarring, and subsequently renal failure and hypertension. Permanent renal damage has been suggested to be caused by the host inflammatory response. Read More

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October 2020

Neutrophil-Macrophage Imbalance Drives the Development of Renal Scarring during Experimental Pyelonephritis.

J Am Soc Nephrol 2021 01 4;32(1):69-85. Epub 2020 Nov 4.

Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio

Background: In children, the acute pyelonephritis that can result from urinary tract infections (UTIs), which commonly ascend from the bladder to the kidney, is a growing concern because it poses a risk of renal scarring and irreversible loss of kidney function. To date, the cellular mechanisms underlying acute pyelonephritis-driven renal scarring remain unknown.

Methods: We used a preclinical model of uropathogenic -induced acute pyelonephritis to determine the contribution of neutrophils and monocytes to resolution of the condition and the subsequent development of kidney fibrosis. Read More

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January 2021

Symptomatology and Clinic of Hydronephrosis Associated With Uretero Pelvic Junction Anomalies.

Authors:
Ilmay Bilge

Front Pediatr 2020 30;8:520. Epub 2020 Sep 30.

Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Koc University, Istanbul, Turkey.

The most common cause of hydronephrosis in the pediatric age group is ureteropelvic junction-type hydronephrosis (UPJHN). Since the advent of widespread maternal ultrasound screening, clinical presentation of hydronephrosis associated with UPJ anomalies has changed dramatically. Today most cases are diagnosed in the prenatal period, and neonates present without signs or symptoms. Read More

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September 2020

Urinary Neutrophil Gelatinase - Associated Lipocalin: A Marker of Urinary Tract Infection Among Febrile Children.

Clin Exp Pediatr 2020 Oct 17. Epub 2020 Oct 17.

Department of Pediatrics, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Korea, Republic.

Background: Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a valuable biomarker of urinary tract infection (UTI) in children.

Purpose: This study aimed to compare the diagnostic accuracy of urinary NGAL (uNGAL) with those of serum C-reactive protein (CRP) and white blood cell (WBC) count for predicting UTI and acute pyelonephritis (APN) in febrile children.

Methods: The medical charts of children undergoing uNGAL measurements between November 2017- and August 2019 were retrospectively reviewed. Read More

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October 2020

Hyponatremia in childhood urinary tract infection.

Eur J Pediatr 2021 Mar 19;180(3):861-867. Epub 2020 Sep 19.

Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.

Acute urinary tract infection (UTI) is the most common bacterial infection in childhood. Although hyponatremia was described in ~ 2/3 of these children, its clinical significance is still unclear. Herein, we evaluated the prevalence and clinical implications of hyponatremia in children hospitalized with a UTI. Read More

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Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children.

Cochrane Database Syst Rev 2020 09 10;9:CD009185. Epub 2020 Sep 10.

General Academic Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.

Background: In children with urinary tract infection (UTI), only those with pyelonephritis (and not cystitis) are at risk for developing long-term renal sequelae. If non-invasive biomarkers could accurately differentiate children with cystitis from children with pyelonephritis, treatment and follow-up could potentially be individualized. This is an update of a review first published in 2015. Read More

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September 2020

Androgen-Influenced Polarization of Activin A-Producing Macrophages Accompanies Post-pyelonephritic Renal Scarring.

Front Immunol 2020 28;11:1641. Epub 2020 Jul 28.

Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States.

Ascending bacterial pyelonephritis, a form of urinary tract infection (UTI) that can result in hospitalization, sepsis, and other complications, occurs in ~250,000 US patients annually; uropathogenic (UPEC) cause a large majority of these infections. Although UTIs are primarily a disease of women, acute pyelonephritis in males is associated with increased mortality and morbidity, including renal scarring, and end-stage renal disease. Preclinical models of UTI have only recently allowed investigation of sex and sex-hormone effects on pathogenesis. Read More

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Childhood Urinary Tract Infections and Pregnancy-Related Complications in Adult Women.

Pediatrics 2020 08 15;146(2). Epub 2020 Jul 15.

Departments of Pediatrics and Adolescent Medicine.

Background And Objectives: Long-term outcomes of urinary tract infection (UTI) in childhood are not well known. Pregnancy may reveal latent renal damage caused by a UTI because of stress on the kidneys.

Methods: Our cohort included adult women with an ultrasonography taken because of a childhood UTI in 1981-1991 ( = 1175). Read More

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Swiss consensus recommendations on urinary tract infections in children.

Eur J Pediatr 2021 Mar 3;180(3):663-674. Epub 2020 Jul 3.

Paediatrics, Lucerne Children's Hospital, Cantonal Hospital Lucerne, Spitalstrasse, 6000, Luzern 16, Switzerland.

The kidneys and the urinary tract are a common source of infection in children of all ages, especially infants and young children. The main risk factors for sequelae after urinary tract infections (UTI) are congenital anomalies of the kidney and urinary tract (CAKUT) and bladder-bowel dysfunction. UTI should be considered in every child with fever without a source. Read More

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Diagnostic performance of contrast-enhanced ultrasound for acute pyelonephritis in children.

Sci Rep 2020 07 1;10(1):10715. Epub 2020 Jul 1.

Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 03312, Republic of Korea.

The objective of our study was to evaluate the performance of renal contrast-enhanced ultrasound (CEUS) against the 99m-labeled dimercaptosuccinic acid (DMSA) scan and computed tomography (CT) in children for the diagnosis of acute pyelonephritis. We included children who underwent both renal CEUS and the DMSA scan or CT. A total of 33 children (21 males and 12 females, mean age 26 ± 36 months) were included. Read More

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Trans IL-6 signaling does not appear to play a role in renal scarring after urinary tract infection.

J Pediatr Urol 2020 Oct 29;16(5):586-591. Epub 2020 May 29.

Department of Pediatric Urology, Nationwide Children's Hospital, Columbus OH, USA; Center for Clinical and Translational Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus OH, USA. Electronic address:

Introduction: While inflammation is an important innate defense mechanism against infection, it can also lead to local tissue damage. The trans signaling pathway of interleukin (IL)-6 is a known mediator of inflammation. We hypothesized that the trans IL-6 signaling pathway is associated with the development of post febrile urinary tract infection (UTI) renal scarring. Read More

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October 2020

School Nurses on the Front Lines of Healthcare: Serious Infections in Students and Their Common Presenting Complaints.

NASN Sch Nurse 2021 Jan 19;36(1):39-44. Epub 2020 Jun 19.

Professor, Departments of Emergency Medicine and Pediatrics, Penn State College of Medicine, Attending Pediatric Emergency Medicine physician, Penn State Hershey Medical Center, Hershey, PA.

School nurses occasionally deal with students presenting with serious infections associated with common chief complaints. Although rare, the implications of missing the signs and symptoms of these infections are potentially life-threatening and devastating, with both immediate and long-term complications. Rapid recognition and stabilization, with immediate transfer to the closest emergency department via emergency medical services for antibiotic administration, is the key to reducing morbidity and mortality associated with these serious infections. Read More

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January 2021

Relationship between low serum vitamin D status and urinary tract infection in children: a case-control study.

Paediatr Int Child Health 2020 08 3;40(3):181-185. Epub 2020 Jun 3.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Urmia University of Medical Sciences , Urmia, Iran.

Background: A link between vitamin D deficiency and susceptibility to bacterial and viral infections has recently been suggested.

Aim: To investigate a possible association between vitamin D deficiency and urinary tract infection (UTI).

Methods: A case-control study was undertaken comprising 75 children aged 2-7 years with UTI (cases) compared with 75 healthy controls in terms of serum 25 hydroxyvitamin D [25(OH)D] levels. Read More

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Developmental loss, but not pharmacological suppression, of renal carbonic anhydrase 2 results in pyelonephritis susceptibility.

Am J Physiol Renal Physiol 2020 06 11;318(6):F1441-F1453. Epub 2020 May 11.

Division of Pediatric Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana.

Carbonic anhydrase II knockout () mice have depleted numbers of renal intercalated cells, which are increasingly recognized to be innate immune effectors. We compared pyelonephritis susceptibility following reciprocal renal transplantations between and wild-type mice. We examined the effect of pharmacological CA suppression using acetazolamide in an experimental murine model of urinary tract infection. Read More

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Comparative Effectiveness of Antibiotic Treatment Duration in Children With Pyelonephritis.

JAMA Netw Open 2020 05 1;3(5):e203951. Epub 2020 May 1.

Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Importance: National guidelines recommend treating children with pyelonephritis for 7 to 14 days of antibiotic therapy, yet data are lacking to suggest a more precise treatment duration.

Objective: To compare the clinical outcomes of children receiving a short-course vs a prolonged-course of antibiotic treatment for pyelonephritis.

Design, Setting, And Participants: Retrospective observational study using inverse probability of treatment weighted propensity score analysis of data from 5 hospitals in Maryland between July 1, 2016, and October 1, 2018. Read More

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Diffusion weighted imaging is a promising method to detect acute pyelonephritis in non-sedated free breathing infants.

J Pediatr Urol 2020 06 6;16(3):320-325. Epub 2020 Apr 6.

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

Introduction: Urinary tract infection (UTI) is a common disease in infants. The initial evaluation includes imaging to identify risk factors for permanent renal damage, such as malformation and renal parenchymal involvement of the infection i.e. Read More

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TGFβ1 orchestrates renal fibrosis following Escherichia coli pyelonephritis.

Physiol Rep 2020 03;8(6):e14401

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

Renal scarring after pyelonephritis is linked to long-term health risks for hypertension and chronic kidney disease. Androgen exposure increases susceptibility to, and severity of, uropathogenic Escherichia coli (UPEC) pyelonephritis and resultant scarring in both male and female mice, while anti-androgen therapy is protective against severe urinary tract infection (UTI) in these models. This work employed androgenized female C57BL/6 mice to elucidate the molecular mechanisms of post-infectious renal fibrosis and to determine how these pathways are altered by the presence of androgens. Read More

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Clinical Characteristics of Pediatric Pyelonephritis Without Pyuria or Bacteriuria.

Pediatr Infect Dis J 2020 05;39(5):385-388

From the Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center.

Background: The gold standard for the diagnosis of acute pyelonephritis (APN) in children is the finding of both pyuria (P) and bacteriuria (B); however, some APN patients have neither of these findings [APN(P(-);B(-))].

Methods: In this study, we investigated APN patients who visited our hospital over 14 years to identify specific clinical characteristics of APN(P(-);B(-)).

Results: A total of 171 APN patients were included in the study, and of these 29 were APN(P(-);B(-)). Read More

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Accuracy of subjective vesicoureteral reflux timing assessment: supporting new voiding cystourethrogram guidelines.

Pediatr Radiol 2020 06 17;50(7):953-957. Epub 2020 Mar 17.

Division of Pediatric Urology, Department of Urology, Emory University School of Medicine, Children's Healthcare of Atlanta, 5730 Glenridge Dr., Suite 200, Atlanta, GA, 30328, USA.

Background: Bladder volume at the onset of vesicoureteral reflux (VUR) is an important prognostic indicator of spontaneous resolution and the risk of pyelonephritis.

Objective: We aim to determine whether pediatric urologists and pediatric radiologists can accurately estimate the timing of reflux by examining voiding cystourethrogram (VCUG) images without prior knowledge of the instilled contrast volume.

Materials And Methods: Total bladder volume and the volume at the time of reflux were collected from VCUG reports to determine the volume at the onset of VUR. Read More

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