Comparison of Acute Lobar Nephronia and Uncomplicated Urinary Tract Infection in Children
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
43
Journal Issue
3
Pages
207-214
Date Issued
2010
Author(s)
Abstract
Background/Purpose: This aim of this study was to assess the clinical manifestations, the microorganisms involved and their antibiotic resistance in children hospitalized due to acute lobar nephronia (ALN) and non-ALN community-acquired urinary tract infections (UTIs). Methods: We retrospectively reviewed the records of 265 previously healthy children hospitalized due to a first-episode of community-acquired febrile UTI between July 2004 and June 2007. Based on the results of renal ultrasonography and computed tomography, they were divided into ALN and non-ALN groups. Their demographic and clinical characteristics, distribution of microorganisms, and their antimicrobial resistance were analyzed. Results: Of the total number of cases of children admitted with a first-episode community-acquired UTI, 19.2% (n=51) were diagnosed as ALN. Children with ALN were older (1.86 years vs. 0.81 years; p < 0.01), had longer periods of fever before admission (4.7 days vs. 1.4 days; p < 0.01), higher peak body temperatures (39.5°C vs. 38.9°C; p < 0.01), higher white cell counts (18.86 × 109/L vs. 15.08 × 109/L; p < 0.01) and higher C-reactive protein levels (9.0 mg/dL vs. 3.5 mg/dL; p < 0.01) compared with non-ALN children. Fever also persisted for longer after the start of antibiotic treatment in the ALN children (2.7 days vs. 1.4 days: p < 0.01) and they required longer hospital stays and incurred higher medical costs. The major pathogen found in ALN was E. coli (90%). The E. coli isolated from ALN children was more resistant to cotrimoxazole and ciprofloxacin than those from non-ALN children. Conclusion: ALN is not uncommon in children with a first-episode febrile UTI. They have a prolonged clinical course, higher inflammatory parameters, longer hospital stays and incur higher medical costs. E. coli is the major pathogen isolated from these children. ? 2010 Taiwan Society of Microbiology.
SDGs
Other Subjects
amoxicillin; ampicillin; antibiotic agent; C reactive protein; ciprofloxacin; clavulanic acid; cotrimoxazole; immunoglobulin; acute lobar nephronia; adolescent; age; antibiotic resistance; antibiotic therapy; article; bacterium isolation; child; childhood disease; communicable disease; comparative study; computer assisted tomography; controlled study; disease duration; echography; Escherichia coli; female; fever; health care cost; human; infant; length of stay; leukocyte count; major clinical study; male; medical record review; nephritis; newborn; preschool child; protein blood level; school child; thrombocytopenic purpura; treatment duration; urinary tract infection; urosepsis; Adolescent; Age Factors; Anti-Bacterial Agents; C-Reactive Protein; Child; Child, Preschool; Community-Acquired Infections; Diagnosis, Differential; Escherichia coli Infections; Female; Fever; Humans; Infant; Infant, Newborn; Leukocyte Count; Male; Microbial Sensitivity Tests; Nephritis; Retrospective Studies; Urinary Tract Infections
Type
journal article