Frequency of Treatment Failure of UTIs in Children With Congenital Urinary Tract Anomalies.

Autor:	Forster CS; University of Pittsburgh, Pittsburgh, Pennsylvania., Wood AC; US Department of Agriculture, Agricultural Research Services, Children's Nutrition Research Center, Houston, Texas., Davis-Rodriguez S; Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio., Chang PW; Seattle Children's Hospital, Seattle, Washington., Desai S; Dell Children's Hospital, Austin, Texas., Tchou M; Children's Hospital Colorado, Aurora, Colorado., Morrison JM; Johns Hopkins University School of Medicine, Baltimore, Maryland., Mudd JD; Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio., Casey BD; Johns Hopkins University School of Medicine, Baltimore, Maryland., Trevisanut V; Dell Children's Hospital, Austin, Texas., Hamdy RF; Children's National Hospital, Washington, District of Columbia., Vemulakonda V; Children's Hospital Colorado, Aurora, Colorado., Brady PW; Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio., Wallace SS; Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
Jazyk:	angličtina
Zdroj:	Hospital pediatrics [Hosp Pediatr] 2024 Mar 01; Vol. 14 (3), pp. 189-196.
DOI:	10.1542/hpeds.2023-007427
Abstrakt:	Objectives: Children with certain congenital anomalies of the kidney and urinary tract and neurogenic bladder (CAKUT/NGB) are at higher risk of treatment failure for urinary tract infections (UTIs) than children with normal genitourinary anatomy, but the literature describing treatment and outcomes is limited. The objectives of this study were to describe the rate of treatment failure in children with CAKUT/NGB and compare duration of antibiotics between those with and without treatment failure. Methods: Multicenter retrospective cohort of children 0 to 17 years old with CAKUT/NGB who presented to the emergency department with fever or hypothermia and were diagnosed with UTI between 2017 and 2018. The outcome of interest was treatment failure, defined as subsequent emergency department visit or hospitalization for UTI because of the same pathogen within 30 days of the index encounter. Descriptive statistics and univariates analyses were used to compare covariates between groups. Results: Of the 2014 patient encounters identified, 482 were included. Twenty-nine (6.0%) of the 482 included encounters had treatment failure. There was no difference in the mean duration of intravenous antibiotics (3.4 ± 2.5 days, 3.5 ± 2.8 days, P = .87) or total antibiotics between children with and without treatment failure (10.2 ± 3.8 days, 10.8 ± 4.0 days, P = .39) Of note, there was a higher rate of bacteremia in children with treatment failure (P = .04). Conclusions: In children with CAKUT/NGB and UTI, 6.0% of encounters had treatment failure. Duration of antibiotics was not associated with treatment failure. Larger studies are needed to assess whether bacteremia modifies the risk of treatment failure. (Copyright © 2024 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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