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Analysis of Uropathogens of Febrile Urinary Tract Infection in Infant and Relationship with Vesicoureteral Reflux
Urogenit Tract Infect 2018 Dec;13(3):58-65
Published online December 31, 2018;  https://doi.org/10.14777/uti.2018.13.3.58
Copyright © 2018 Korean Association of Urogenital Tract Infection and Inflammation.

Kyung Hwan Kim1,2, Seung Hee Seo3,4, Sang Don Lee1,3, Jae Min Chung1,3

1Department of Urology, Pusan National University School of Medicine, Yangsan, 2Department of Urology, Pusan National University Hospital, Busan, 3Department of Urology, Pusan National University Yangsan Hospital, Yangsan, 4Department of Nursing, Pusan National University Graduate School, Yangsan, Korea
Correspondence to: Jae Min Chung
https://orcid.org/0000-0002-7467-5954
Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea
Tel: +82-55-360-2134, Fax: +82-55-360-2164
E-mail: busanuro@hanmail.net
Received August 11, 2018; Revised October 3, 2018; Accepted October 17, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: This study aimed to investigate the relationship between uropathogens of infants with febrile urinary tract infection (UTI) and vesicoureteral reflux (VUR).
Materials and Methods: We analyzed 308 infants hospitalized for febrile UTI between January 2010 and December 2015, and assessed the voiding cystourethrography (VCUG). The medical records, including clinical symptoms, laboratory findings, urinalysis, urine culture tests, ultrasound (US), dimercaptosuccinic acid scan, and VCUG, were retrospectively obtained. The incidences of VUR and high-grade VURs (III, IV, and V) were analyzed in 4 groups categorized by uropathogens and renal US findings.
Results: The mean age of 308 infants was 3.29±2.18 months. The male-to-female ratio was 3.46:1. In urine culture tests, 267 infants (86.69%) showed single bacterial uropathogen; Escherichia coli in 241 infants (78.25%) and non-E. coli uropathogens in 26 infants (8.44%). Multiple distinctive microorganisms were identified as causative uropathogens in 41 infants (13.31%). Abnormal findings of US and VCUG were identified in 216 and 64 patients, respectively. In 308 infants, the incidences of VUR and high-grade VUR were not different among the 4 groups. In 239 male infants, the incidences of high-grade VUR were higher in patients with non-E. coli single or multiple uropathogen and with abnormal US findings (p=0.042).
Conclusions: In male infants with non-E. coli uropathogen or multiple uropathogens and with abnormal US findings at febrile UTI, there was an increased chance of finding high-grade VURs on subsequent VCUG tests.
Keywords : Urinary tract infections; Infant; Kidney; Vesicoureteral reflux


December 2018, 13 (3)

  • The official journal of

    The Korean Association of Urogenital Tract Infection and Inflammation

    The Korean Continence Society

    The Han-nam Urological Association

    The Korean Society of Geriatric Urological Care