Clinical Significance and Incidence of Gram-positive Uropathogens in Pediatric Patients Younger than 1 Year of Age with Febrile Urinary Tract Infection.
- Author:
Tae Hwan YANG
1
;
Hyung Eun YIM
;
Kee Hwan YOO
Author Information
1. Department of Pediatrics, College of Medicine, Korea University, Korea. he-yim@hanmail.net
- Publication Type:Original Article
- Keywords:
Fever duration;
Gram-positive uropathogens;
Urinary tract infection;
Vesicoureteral reflux
- MeSH:
Academic Medical Centers;
C-Reactive Protein;
Child;
Cicatrix;
Enterococcus faecalis;
Escherichia coli;
Fever;
Gram-Negative Bacteria;
Gram-Positive Bacteria;
Humans;
Hydronephrosis;
Incidence*;
Korea;
Leukocytes;
Medical Records;
Retrospective Studies;
Urinary Tract Infections*;
Urinary Tract*;
Vesico-Ureteral Reflux
- From:Journal of the Korean Society of Pediatric Nephrology
2013;17(2):65-72
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Urinary tract infection (UTI) caused by gram-positive uropathogens is usually hospital-acquired and associated with predisposing conditions. However, the incidence of gram-positive bacteria in community-acquired UTIs has recently increased worldwide. We aimed to investigate the clinical significance of UTI and associated genitourinary malformations in young children with febrile UTIs caused by gram-positive bacteria. METHODS: We retrospectively reviewed the medical records of 566 patients (age, <1 year) who visited the Korea University Medical Center for febrile UTIs between January 2008 and May 2013. We classified the patients into the following two groups: gram-positive (P group) and gram-negative (N group), according to the results of urine culture. The fever duration; white blood cell (WBC) counts and C-reactive protein (CRP) levels in peripheral blood; and the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR), and renal scarring were compared between the two groups. RESULTS: The number of patients with gram-positive bacteria was 23 (4.1%) and with gram-negative bacteria was 543 (95.9%). The most common pathogen was Escherichia coli, and Enterococcus faecalis showed the highest incidence among gram-positive uropathogens. Patients with gram-positive bacteria showed longer fever duration compared to that in patients with gram-negative bacteria (P vs. N, 3.4+/-1.2 vs. 2.9+/-1.6 days, P<0.05). The incidence of VUR was increased in the gram-positive group compared to that in the gram-negative group (P vs. N, 55.6 vs. 17.8%, P<0.05). However, there were no significant differences in other laboratory and radiologic findings. CONCLUSION: The findings of our study show that community-acquired UTIs in patients younger than 1 year of age, caused by gram-positive uropathogens, can be associated with prolonged fever duration and the presence of VUR.
