Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Are the Clinical outcomes of Neonates and Infants Under 2 Months Old with Urinary Tract Infections Similar to those in Infants 2 to 12 Months Old?

  • Lee, Jee Hoo (Department of Pediatrics, College of Medicine, Korea University) ;
  • Lim, Hyunwook (Department of Pediatrics, College of Medicine, Korea University) ;
  • Kim, Kyungju (Department of Pediatrics, College of Medicine, Korea University) ;
  • Yim, Hyung Eun (Department of Pediatrics, College of Medicine, Korea University) ;
  • Yoo, Kee Hwan (Department of Pediatrics, College of Medicine, Korea University)
  • Received : 2015.08.18
  • Accepted : 2015.10.13
  • Published : 2015.10.30
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Abstract

Purpose: Although the American Academy of Pediatrics provides clinical guidelines for urinary tract infection (UTI) infants, guidelines are not appropriate for neonates and infants less than 2 months of age due to insufficient data. The aim of this study was to evaluate the characteristics of neonates and young infants less than 2 months old (group 1) with UTI compared to older infants from 2 to 12 months old (group 2). Methods: We reviewed UTI patients aged 0 to 12 months admitted to the pediatric department in the last 5 years. Clinical characteristics such as age, sex, fever duration, recurrence, progression to acute pyelonephritis (APN), malformations like hydronephrosis and vesicoureteral reflux (VUR), and laboratory results were compared between group 1 and group 2. Results: 615 patients were included in this study. Group 1 had 94 cases and group 2 had 521 cases. Escherichia coli was the most commonly isolated pathogen in urine cultures. Fever duration was shorter in group 1 (vs.) 2 ($1.91{\pm}1.43$ days vs. $3.42{\pm}2.40$ days, P<0.05). As compared to group 2, group 1 had a higher proportion of patients with antenatal hydronephrosis and hydronephrosis found after admission (10.6% vs. 3.6% and 75.5% vs. 55.9%, P<0.05). There were differences between two groups in white blood cell (WBC) count (Group 1: $13,694{\pm}5,315/{\mu}L$, Group 2: $15,271{\pm}6,130/{\mu}L$, P<0.05) and C-reactive protein (Group 1: $32.02{\pm}35.17mg/L$, Group 2: $46.51{\pm}46.63mg/L$, P<0.05). Conclusion: Compared to older infants, UTI in neonates and young infants shows milder clinical manifestations except higher rates of hydronephrosis but outcome is alike.

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References

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