Child Kidney Dis.  2024 Feb;28(1):35-43. 10.3339/ckd.24.003.

Risk factors for recurrent urinary tract infections in young infants under the age of 24 months

• Son MH
• Yim HE

• KMID: 2553178
• DOI: http://doi.org/10.3339/ckd.24.003

Abstract

Purpose
Recurrent urinary tract infections (UTIs) in children is a major challenge for pediatricians. This study was designed to investigate the risk factors for recurrent UTIs and determine the association between recurrent UTIs and clinical findings, including growth patterns in infants and children younger than 24 months of age.
Methods
We retrospectively reviewed the medical records of 147 patients <24 months of age with UTIs who were hospitalized between August 2018 and October 2021. The patients were divided into recurrent and single UTI episode groups. Clinical findings and anthropometric and laboratory data were compared between the two groups.
Results
In the recurrent UTI group, the weight-for-length (WFL) percentile at the first UTI diagnosis was lower compared to the single UTI episode group, and the weight-for-age percentile at 3-month and 6-month follow-ups after the first UTI decreased (all P<0.05). In univariable logistic regression analysis, higher birth weight, lower WFL percentile, the presence of hydronephrosis, acute pyelonephritis or vesicoureteral reflux, the use of prophylactic antibiotics, and non-Escherichia coli infections were associated with the development of recurrent UTIs (all P<0.05). However, in the multivariable analysis, only the presence of hydronephrosis and prophylactic antibiotic use were independently related to UTI recurrence (P<0.05).
Conclusion
The presence of hydronephrosis at the first UTI can be helpful for predicting UTI recurrence in young children aged < 24 months. Antibiotic prophylaxis may be associated with UTI recurrence. Potential growth delay should be carefully monitored in infants with recurrent UTI.

Keyword

Body-weight trajectory; Growth; Hydronephrosis; Recurrence; Urinary tract infections

Figure

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  Fig. 1. Study flow diagram. UTI, urinary tract infection; CAKUT, congenital anomalies of the kidney and the urinary tract; VUR, vesicoureteral reflux.

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  Fig. 2. (A) Comparison of weight percentiles at 0, 3, and 6 months after the first UTI in the single and recurrent UTI groups. (B) Comparison of weight-for-length percentiles in the first and second episodes in the recurrent UTI group. UTI, urinary tract infection. *P<0.05, **P<0.01.

Reference

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