Is ultrasonography mandatory in all children at their first febrile urinary tract infection?
Background This study investigated whether performing kidney ultrasound (KUS) only in children presenting either a pathogen other than E. coli at their first febrile urinary tract infection (fUTI) or experiencing fUTI recurrence would increase missed diagnoses of kidney anomalies. Methods Patients a...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2021-07, Vol.36 (7), p.1809-1816 |
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| container_title | Pediatric nephrology (Berlin, West) |
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| creator | Pennesi, Marco Amoroso, Stefano Pennesi, Giulia Giangreco, Manuela Cattaruzzi, Elisabetta Pesce, Marco Busetti, Marina Barbi, Egidio Conversano, Ester |
| description | Background
This study investigated whether performing kidney ultrasound (KUS) only in children presenting either a pathogen other than
E. coli
at their first febrile urinary tract infection (fUTI) or experiencing fUTI recurrence would increase missed diagnoses of kidney anomalies.
Methods
Patients aged 2–36 months with fUTI who underwent KUS evaluation from 2 January 2013 to 31 June 2018 were enrolled. Cystourethrography was performed after pathological KUS or recurring fUTIs. Thereafter, we retrospectively assessed the detection rate of kidney anomalies through performing KUS only in patients with atypical pathogen at first fUTI or with recurring fUTIs.
Results
In 263 patients included, the isolated pathogen was
E. coli
in 223 cases (84.8%) and atypical in 40 cases (15.2%). KUS detected kidney anomalies in 14/223 (6.3%) of fUTIs caused by
E. coli
and in 11/40 (27.5%) of fUTIs caused by an atypical pathogen (OR 5.5, 95%CI 2.5–14.5). Cystourethrography was performed in 40 patients and vesicoureteral reflux (VUR) found in 20 cases. None of the high grade VUR diagnoses or other kidney anomalies would have been lost through a different diagnostic protocol that required the presence of an atypical pathogen at the first fUTI or a fUTI recurrence to perform the KUS.
Conclusions
A diagnostic protocol that requires presence of an atypical pathogen at the first fUTI or a second episode of fUTI to perform the KUS would allow a reduction in the number of negative ultrasounds with a negligible risk of missed diagnoses of kidney anomalies. |
| doi_str_mv | 10.1007/s00467-020-04909-5 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2480272368</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A666293925</galeid><sourcerecordid>A666293925</sourcerecordid><originalsourceid>FETCH-LOGICAL-c511t-b1010ebefde67301b9bebacdb9fc8aa3d0944424c87784d863776046334d92423</originalsourceid><addsrcrecordid>eNp9kk1rFTEYhYMo9vbqH3AhA4J0MzVfk0lWUoofhYIbhS6EkMm8cyclM7kmmUX_vRlvtVYukkUIec4h581B6BXB5wTj9l3CmIu2xhTXmCus6uYJ2hDOaE2UvHmKNlgxUq7IzQk6TekWYywbKZ6jE8a4JMVjg75fpWrxOZoU5rCLZj_eVZOZe5NDvKvcXBnvKzs630coh1zlEVysBhdTrgboovNQLdHNpuDFxuYiGsBmF-b3L9CzwfgEL-_3Lfr28cPXy8_19ZdPV5cX17VtCMl1RzDB0MHQg2gZJp3qoDO279RgpTGsx4pzTrmVbSt5LwVrW1GilxS9opyyLTo7-O5j-LFAynpyyYL3ZoawJE25xLSlTMiCvvkHvQ1LnMvrNG2YIJSyhj1QO-NBl0Bhjbaa6gshBFVMFXqL6iPUDmaIxocZhjKbx_z5Eb6sHiZnjwre_iUYwfg8puCXdbjpMUgPoI0hpQiD3kc3lS_RBOu1K_rQFV26on91Ra-i1_ejWLoJ-j-S3-UoADsAqVzNO4gPs_qP7U-08sbL</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2536122353</pqid></control><display><type>article</type><title>Is ultrasonography mandatory in all children at their first febrile urinary tract infection?</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Pennesi, Marco ; Amoroso, Stefano ; Pennesi, Giulia ; Giangreco, Manuela ; Cattaruzzi, Elisabetta ; Pesce, Marco ; Busetti, Marina ; Barbi, Egidio ; Conversano, Ester</creator><creatorcontrib>Pennesi, Marco ; Amoroso, Stefano ; Pennesi, Giulia ; Giangreco, Manuela ; Cattaruzzi, Elisabetta ; Pesce, Marco ; Busetti, Marina ; Barbi, Egidio ; Conversano, Ester</creatorcontrib><description>Background
This study investigated whether performing kidney ultrasound (KUS) only in children presenting either a pathogen other than
E. coli
at their first febrile urinary tract infection (fUTI) or experiencing fUTI recurrence would increase missed diagnoses of kidney anomalies.
Methods
Patients aged 2–36 months with fUTI who underwent KUS evaluation from 2 January 2013 to 31 June 2018 were enrolled. Cystourethrography was performed after pathological KUS or recurring fUTIs. Thereafter, we retrospectively assessed the detection rate of kidney anomalies through performing KUS only in patients with atypical pathogen at first fUTI or with recurring fUTIs.
Results
In 263 patients included, the isolated pathogen was
E. coli
in 223 cases (84.8%) and atypical in 40 cases (15.2%). KUS detected kidney anomalies in 14/223 (6.3%) of fUTIs caused by
E. coli
and in 11/40 (27.5%) of fUTIs caused by an atypical pathogen (OR 5.5, 95%CI 2.5–14.5). Cystourethrography was performed in 40 patients and vesicoureteral reflux (VUR) found in 20 cases. None of the high grade VUR diagnoses or other kidney anomalies would have been lost through a different diagnostic protocol that required the presence of an atypical pathogen at the first fUTI or a fUTI recurrence to perform the KUS.
Conclusions
A diagnostic protocol that requires presence of an atypical pathogen at the first fUTI or a second episode of fUTI to perform the KUS would allow a reduction in the number of negative ultrasounds with a negligible risk of missed diagnoses of kidney anomalies.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-020-04909-5</identifier><identifier>PMID: 33481100</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Child ; Children ; Diagnosis ; Diagnostic imaging ; E coli ; Escherichia coli ; Health aspects ; Humans ; Infant ; Kidney Diseases ; Kidneys ; Medicine ; Medicine & Public Health ; Methods ; Nephrology ; Original Article ; Pathogenic microorganisms ; Pathogens ; Pediatric research ; Pediatrics ; Recurrence ; Retrospective Studies ; Ultrasonography ; Ultrasound ; Urinary tract ; Urinary tract diseases ; Urinary tract infections ; Urinary Tract Infections - diagnostic imaging ; Urogenital system ; Urology ; Vesico-Ureteral Reflux - diagnostic imaging</subject><ispartof>Pediatric nephrology (Berlin, West), 2021-07, Vol.36 (7), p.1809-1816</ispartof><rights>IPNA 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>IPNA 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-b1010ebefde67301b9bebacdb9fc8aa3d0944424c87784d863776046334d92423</citedby><cites>FETCH-LOGICAL-c511t-b1010ebefde67301b9bebacdb9fc8aa3d0944424c87784d863776046334d92423</cites><orcidid>0000-0002-2877-0248</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-020-04909-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-020-04909-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33481100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pennesi, Marco</creatorcontrib><creatorcontrib>Amoroso, Stefano</creatorcontrib><creatorcontrib>Pennesi, Giulia</creatorcontrib><creatorcontrib>Giangreco, Manuela</creatorcontrib><creatorcontrib>Cattaruzzi, Elisabetta</creatorcontrib><creatorcontrib>Pesce, Marco</creatorcontrib><creatorcontrib>Busetti, Marina</creatorcontrib><creatorcontrib>Barbi, Egidio</creatorcontrib><creatorcontrib>Conversano, Ester</creatorcontrib><title>Is ultrasonography mandatory in all children at their first febrile urinary tract infection?</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background
This study investigated whether performing kidney ultrasound (KUS) only in children presenting either a pathogen other than
E. coli
at their first febrile urinary tract infection (fUTI) or experiencing fUTI recurrence would increase missed diagnoses of kidney anomalies.
Methods
Patients aged 2–36 months with fUTI who underwent KUS evaluation from 2 January 2013 to 31 June 2018 were enrolled. Cystourethrography was performed after pathological KUS or recurring fUTIs. Thereafter, we retrospectively assessed the detection rate of kidney anomalies through performing KUS only in patients with atypical pathogen at first fUTI or with recurring fUTIs.
Results
In 263 patients included, the isolated pathogen was
E. coli
in 223 cases (84.8%) and atypical in 40 cases (15.2%). KUS detected kidney anomalies in 14/223 (6.3%) of fUTIs caused by
E. coli
and in 11/40 (27.5%) of fUTIs caused by an atypical pathogen (OR 5.5, 95%CI 2.5–14.5). Cystourethrography was performed in 40 patients and vesicoureteral reflux (VUR) found in 20 cases. None of the high grade VUR diagnoses or other kidney anomalies would have been lost through a different diagnostic protocol that required the presence of an atypical pathogen at the first fUTI or a fUTI recurrence to perform the KUS.
Conclusions
A diagnostic protocol that requires presence of an atypical pathogen at the first fUTI or a second episode of fUTI to perform the KUS would allow a reduction in the number of negative ultrasounds with a negligible risk of missed diagnoses of kidney anomalies.</description><subject>Child</subject><subject>Children</subject><subject>Diagnosis</subject><subject>Diagnostic imaging</subject><subject>E coli</subject><subject>Escherichia coli</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Infant</subject><subject>Kidney Diseases</subject><subject>Kidneys</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methods</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Pathogenic microorganisms</subject><subject>Pathogens</subject><subject>Pediatric research</subject><subject>Pediatrics</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Ultrasonography</subject><subject>Ultrasound</subject><subject>Urinary tract</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urinary Tract Infections - diagnostic imaging</subject><subject>Urogenital system</subject><subject>Urology</subject><subject>Vesico-Ureteral Reflux - diagnostic imaging</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kk1rFTEYhYMo9vbqH3AhA4J0MzVfk0lWUoofhYIbhS6EkMm8cyclM7kmmUX_vRlvtVYukkUIec4h581B6BXB5wTj9l3CmIu2xhTXmCus6uYJ2hDOaE2UvHmKNlgxUq7IzQk6TekWYywbKZ6jE8a4JMVjg75fpWrxOZoU5rCLZj_eVZOZe5NDvKvcXBnvKzs630coh1zlEVysBhdTrgboovNQLdHNpuDFxuYiGsBmF-b3L9CzwfgEL-_3Lfr28cPXy8_19ZdPV5cX17VtCMl1RzDB0MHQg2gZJp3qoDO279RgpTGsx4pzTrmVbSt5LwVrW1GilxS9opyyLTo7-O5j-LFAynpyyYL3ZoawJE25xLSlTMiCvvkHvQ1LnMvrNG2YIJSyhj1QO-NBl0Bhjbaa6gshBFVMFXqL6iPUDmaIxocZhjKbx_z5Eb6sHiZnjwre_iUYwfg8puCXdbjpMUgPoI0hpQiD3kc3lS_RBOu1K_rQFV26on91Ra-i1_ejWLoJ-j-S3-UoADsAqVzNO4gPs_qP7U-08sbL</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Pennesi, Marco</creator><creator>Amoroso, Stefano</creator><creator>Pennesi, Giulia</creator><creator>Giangreco, Manuela</creator><creator>Cattaruzzi, Elisabetta</creator><creator>Pesce, Marco</creator><creator>Busetti, Marina</creator><creator>Barbi, Egidio</creator><creator>Conversano, Ester</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2877-0248</orcidid></search><sort><creationdate>20210701</creationdate><title>Is ultrasonography mandatory in all children at their first febrile urinary tract infection?</title><author>Pennesi, Marco ; Amoroso, Stefano ; Pennesi, Giulia ; Giangreco, Manuela ; Cattaruzzi, Elisabetta ; Pesce, Marco ; Busetti, Marina ; Barbi, Egidio ; Conversano, Ester</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-b1010ebefde67301b9bebacdb9fc8aa3d0944424c87784d863776046334d92423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Child</topic><topic>Children</topic><topic>Diagnosis</topic><topic>Diagnostic imaging</topic><topic>E coli</topic><topic>Escherichia coli</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Infant</topic><topic>Kidney Diseases</topic><topic>Kidneys</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methods</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Pathogenic microorganisms</topic><topic>Pathogens</topic><topic>Pediatric research</topic><topic>Pediatrics</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Ultrasonography</topic><topic>Ultrasound</topic><topic>Urinary tract</topic><topic>Urinary tract diseases</topic><topic>Urinary tract infections</topic><topic>Urinary Tract Infections - diagnostic imaging</topic><topic>Urogenital system</topic><topic>Urology</topic><topic>Vesico-Ureteral Reflux - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pennesi, Marco</creatorcontrib><creatorcontrib>Amoroso, Stefano</creatorcontrib><creatorcontrib>Pennesi, Giulia</creatorcontrib><creatorcontrib>Giangreco, Manuela</creatorcontrib><creatorcontrib>Cattaruzzi, Elisabetta</creatorcontrib><creatorcontrib>Pesce, Marco</creatorcontrib><creatorcontrib>Busetti, Marina</creatorcontrib><creatorcontrib>Barbi, Egidio</creatorcontrib><creatorcontrib>Conversano, Ester</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pennesi, Marco</au><au>Amoroso, Stefano</au><au>Pennesi, Giulia</au><au>Giangreco, Manuela</au><au>Cattaruzzi, Elisabetta</au><au>Pesce, Marco</au><au>Busetti, Marina</au><au>Barbi, Egidio</au><au>Conversano, Ester</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is ultrasonography mandatory in all children at their first febrile urinary tract infection?</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>36</volume><issue>7</issue><spage>1809</spage><epage>1816</epage><pages>1809-1816</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Background
This study investigated whether performing kidney ultrasound (KUS) only in children presenting either a pathogen other than
E. coli
at their first febrile urinary tract infection (fUTI) or experiencing fUTI recurrence would increase missed diagnoses of kidney anomalies.
Methods
Patients aged 2–36 months with fUTI who underwent KUS evaluation from 2 January 2013 to 31 June 2018 were enrolled. Cystourethrography was performed after pathological KUS or recurring fUTIs. Thereafter, we retrospectively assessed the detection rate of kidney anomalies through performing KUS only in patients with atypical pathogen at first fUTI or with recurring fUTIs.
Results
In 263 patients included, the isolated pathogen was
E. coli
in 223 cases (84.8%) and atypical in 40 cases (15.2%). KUS detected kidney anomalies in 14/223 (6.3%) of fUTIs caused by
E. coli
and in 11/40 (27.5%) of fUTIs caused by an atypical pathogen (OR 5.5, 95%CI 2.5–14.5). Cystourethrography was performed in 40 patients and vesicoureteral reflux (VUR) found in 20 cases. None of the high grade VUR diagnoses or other kidney anomalies would have been lost through a different diagnostic protocol that required the presence of an atypical pathogen at the first fUTI or a fUTI recurrence to perform the KUS.
Conclusions
A diagnostic protocol that requires presence of an atypical pathogen at the first fUTI or a second episode of fUTI to perform the KUS would allow a reduction in the number of negative ultrasounds with a negligible risk of missed diagnoses of kidney anomalies.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33481100</pmid><doi>10.1007/s00467-020-04909-5</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2877-0248</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-041X |
| ispartof | Pediatric nephrology (Berlin, West), 2021-07, Vol.36 (7), p.1809-1816 |
| issn | 0931-041X 1432-198X |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Child Children Diagnosis Diagnostic imaging E coli Escherichia coli Health aspects Humans Infant Kidney Diseases Kidneys Medicine Medicine & Public Health Methods Nephrology Original Article Pathogenic microorganisms Pathogens Pediatric research Pediatrics Recurrence Retrospective Studies Ultrasonography Ultrasound Urinary tract Urinary tract diseases Urinary tract infections Urinary Tract Infections - diagnostic imaging Urogenital system Urology Vesico-Ureteral Reflux - diagnostic imaging |
| title | Is ultrasonography mandatory in all children at their first febrile urinary tract infection? |
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