Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction.
Pediatrics
; 137(1)2016 Jan.
Article
em En
| MEDLINE
| ID: mdl-26647376
ABSTRACT
BACKGROUND:
Little generalizable information is available on the outcomes of children diagnosed with bladder and bowel dysfunction (BBD) after a urinary tract infection (UTI). Our objectives were to describe the clinical characteristics of children with BBD and to examine the effects of BBD on patient outcomes in children with and without vesicoureteral reflux (VUR).METHODS:
We combined data from 2 longitudinal studies (Randomized Intervention for Children With Vesicoureteral Reflux and Careful Urinary Tract Infection Evaluation) in which children <6 years of age with a first or second UTI were followed for 2 years. We compared outcomes for children with and without BBD, children with and without VUR, and children with VUR randomly assigned to prophylaxis or placebo. The outcomes examined were incidence of recurrent UTIs, renal scarring, surgical intervention, resolution of VUR, and treatment failure.RESULTS:
BBD was present at baseline in 54% of the 181 toilet-trained children included; 94% of children with BBD reported daytime wetting, withholding maneuvers, or constipation. In children not on antimicrobial prophylaxis, 51% of those with both BBD and VUR experienced recurrent UTIs, compared with 20% of those with VUR alone, 35% with BBD alone, and 32% with neither BBD nor VUR. BBD was not associated with any of the other outcomes investigated.CONCLUSIONS:
Among toilet-trained children, those with both BBD and VUR are at higher risk of developing recurrent UTIs than children with isolated VUR or children with isolated BBD and, accordingly, exhibit the greatest benefit from antimicrobial prophylaxis.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções Urinárias
/
Refluxo Vesicoureteral
/
Doenças da Bexiga Urinária
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Enteropatias
/
Anti-Infecciosos
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Child, preschool
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Female
/
Humans
/
Male
Idioma:
En
Revista:
Pediatrics
Ano de publicação:
2016
Tipo de documento:
Article