Laboratory and Imaging Characteristics of Children Suffering from UTI from Infancy to Age Five Years

Introduction: UTI is the most common cause of hospitalization in children with high fever especially in infancy, its more common to be the source for bacteremia in this age. 30% of children who have had the first infection of pyelonephritis will develop a recurrent UTI when the infection occurs in the first year of life. The most common bacteria to cause these infections are E-coli, later Gram(-)bacteria and gram(+) bacteria such as Enterococci. ESBL + resistant bacteria have been found more as uropathogenic in recurrent UTI.

Results: The study is retrospective that included infants and children up to the age of five who were hospitalized in northern Israel in the pediatric department between 2010-2019, with the diagnosis of the first episode of UTI or recurrent episodes in the first five years of life. The children underwent laboratory tests including (CBC), kidney and electrolyte functions, (CRP), blood culture, and urine sample. In most children, empiric antibiotic therapy of Ampcilin and aminoglycoside was started. Most children underwent renal ultrasound, 35% had pathological imaging of hydronephrosis, and some with hydroureter. 40% of the children who underwent cystography had reflux with varying degrees, 60% of those who did mapping (DMSA) were pathological mapping. 18% of children with normal DMSA results had reflux

Conclusion: Initiating empirical treatment of UTI is very important in preventing renal scar development. Recurrent UTI are characterized by various uropathogenic bacteria and a tendency to antibiotic resistance. Cystography is not required in most cases of upper UTI. Kidney mapping by DMSA can reveal the additional value of kidney damage