Urinary Imaging Findings in Young Infants With Bacteremic Urinary Tract Infection

Pearl W. Chang, Jennifer M. Abidari, Mark W. Shen, Tara L. Greenhow, Michael Bendel-Stenzel, Heidi K. Roman, Eric A. Biondi, Alan R. Schroeder, PRIS Bacteremic UTI Investigators

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To describe renal ultrasound (RUS) and voiding cystourethrogram (VCUG) findings and determine predictors of abnormal imaging in young infants with bacteremic urinary tract infection (UTI).

METHODS: We used retrospective data from a multicenter sample of infants younger than 3 months with bacteremic UTI, defined as the same pathogenic organism in blood and urine. Infants were excluded if they had any major comorbidities, known urologic abnormalities at time of presentation, required intensive unit care, or had no imaging performed. Imaging results as stated in the radiology reports were categorized by a pediatric urologist.

RESULTS: Of the 276 infants, 19 were excluded. Of the remaining 257 infants, 254 underwent a RUS and 224 underwent a VCUG. Fifty-five percent had ≥1 RUS abnormalities. Thirty-four percent had ≥1 VCUG abnormalities, including vesicoureteral reflux (VUR, 27%), duplication (1.3%), and infravesicular abnormality (0.9%). Age <1 month, male sex, and non-Escherichia coli organism predicted an abnormal RUS, but only non-E coli organism predicted an abnormal VCUG. Seventeen of 96 infants (17.7%) with a normal RUS had an abnormal VCUG: 15 with VUR (Grade I-III = 13, Grade IV = 2), 2 with elevated postvoid residual, and 1 with infravesical abnormality.

CONCLUSIONS: Although RUS and VCUG abnormalities were common in this cohort, the frequency and severity were similar to previous studies of infants with UTIs in general. Our findings do not support special consideration of bacteremia in imaging decisions for otherwise well-appearing young infants with UTI.

Original languageEnglish (US)
Pages (from-to)647-652
Number of pages6
JournalHospital pediatrics
Volume6
Issue number11
StatePublished - Nov 1 2016

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Urinary Tract Infections
Kidney
Vesico-Ureteral Reflux
Bacteremia
Radiology
Intensive Care Units
Comorbidity
Urine
Pediatrics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Chang, P. W., Abidari, J. M., Shen, M. W., Greenhow, T. L., Bendel-Stenzel, M., Roman, H. K., ... PRIS Bacteremic UTI Investigators (2016). Urinary Imaging Findings in Young Infants With Bacteremic Urinary Tract Infection. Hospital pediatrics, 6(11), 647-652.

Urinary Imaging Findings in Young Infants With Bacteremic Urinary Tract Infection. / Chang, Pearl W.; Abidari, Jennifer M.; Shen, Mark W.; Greenhow, Tara L.; Bendel-Stenzel, Michael; Roman, Heidi K.; Biondi, Eric A.; Schroeder, Alan R.; PRIS Bacteremic UTI Investigators.

In: Hospital pediatrics, Vol. 6, No. 11, 01.11.2016, p. 647-652.

Research output: Contribution to journalArticle

Chang, PW, Abidari, JM, Shen, MW, Greenhow, TL, Bendel-Stenzel, M, Roman, HK, Biondi, EA, Schroeder, AR & PRIS Bacteremic UTI Investigators 2016, 'Urinary Imaging Findings in Young Infants With Bacteremic Urinary Tract Infection', Hospital pediatrics, vol. 6, no. 11, pp. 647-652.
Chang PW, Abidari JM, Shen MW, Greenhow TL, Bendel-Stenzel M, Roman HK et al. Urinary Imaging Findings in Young Infants With Bacteremic Urinary Tract Infection. Hospital pediatrics. 2016 Nov 1;6(11):647-652.
Chang, Pearl W. ; Abidari, Jennifer M. ; Shen, Mark W. ; Greenhow, Tara L. ; Bendel-Stenzel, Michael ; Roman, Heidi K. ; Biondi, Eric A. ; Schroeder, Alan R. ; PRIS Bacteremic UTI Investigators. / Urinary Imaging Findings in Young Infants With Bacteremic Urinary Tract Infection. In: Hospital pediatrics. 2016 ; Vol. 6, No. 11. pp. 647-652.
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abstract = "OBJECTIVES: To describe renal ultrasound (RUS) and voiding cystourethrogram (VCUG) findings and determine predictors of abnormal imaging in young infants with bacteremic urinary tract infection (UTI).METHODS: We used retrospective data from a multicenter sample of infants younger than 3 months with bacteremic UTI, defined as the same pathogenic organism in blood and urine. Infants were excluded if they had any major comorbidities, known urologic abnormalities at time of presentation, required intensive unit care, or had no imaging performed. Imaging results as stated in the radiology reports were categorized by a pediatric urologist.RESULTS: Of the 276 infants, 19 were excluded. Of the remaining 257 infants, 254 underwent a RUS and 224 underwent a VCUG. Fifty-five percent had ≥1 RUS abnormalities. Thirty-four percent had ≥1 VCUG abnormalities, including vesicoureteral reflux (VUR, 27{\%}), duplication (1.3{\%}), and infravesicular abnormality (0.9{\%}). Age <1 month, male sex, and non-Escherichia coli organism predicted an abnormal RUS, but only non-E coli organism predicted an abnormal VCUG. Seventeen of 96 infants (17.7{\%}) with a normal RUS had an abnormal VCUG: 15 with VUR (Grade I-III = 13, Grade IV = 2), 2 with elevated postvoid residual, and 1 with infravesical abnormality.CONCLUSIONS: Although RUS and VCUG abnormalities were common in this cohort, the frequency and severity were similar to previous studies of infants with UTIs in general. Our findings do not support special consideration of bacteremia in imaging decisions for otherwise well-appearing young infants with UTI.",
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AU - Chang, Pearl W.

AU - Abidari, Jennifer M.

AU - Shen, Mark W.

AU - Greenhow, Tara L.

AU - Bendel-Stenzel, Michael

AU - Roman, Heidi K.

AU - Biondi, Eric A.

AU - Schroeder, Alan R.

AU - PRIS Bacteremic UTI Investigators

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N2 - OBJECTIVES: To describe renal ultrasound (RUS) and voiding cystourethrogram (VCUG) findings and determine predictors of abnormal imaging in young infants with bacteremic urinary tract infection (UTI).METHODS: We used retrospective data from a multicenter sample of infants younger than 3 months with bacteremic UTI, defined as the same pathogenic organism in blood and urine. Infants were excluded if they had any major comorbidities, known urologic abnormalities at time of presentation, required intensive unit care, or had no imaging performed. Imaging results as stated in the radiology reports were categorized by a pediatric urologist.RESULTS: Of the 276 infants, 19 were excluded. Of the remaining 257 infants, 254 underwent a RUS and 224 underwent a VCUG. Fifty-five percent had ≥1 RUS abnormalities. Thirty-four percent had ≥1 VCUG abnormalities, including vesicoureteral reflux (VUR, 27%), duplication (1.3%), and infravesicular abnormality (0.9%). Age <1 month, male sex, and non-Escherichia coli organism predicted an abnormal RUS, but only non-E coli organism predicted an abnormal VCUG. Seventeen of 96 infants (17.7%) with a normal RUS had an abnormal VCUG: 15 with VUR (Grade I-III = 13, Grade IV = 2), 2 with elevated postvoid residual, and 1 with infravesical abnormality.CONCLUSIONS: Although RUS and VCUG abnormalities were common in this cohort, the frequency and severity were similar to previous studies of infants with UTIs in general. Our findings do not support special consideration of bacteremia in imaging decisions for otherwise well-appearing young infants with UTI.

AB - OBJECTIVES: To describe renal ultrasound (RUS) and voiding cystourethrogram (VCUG) findings and determine predictors of abnormal imaging in young infants with bacteremic urinary tract infection (UTI).METHODS: We used retrospective data from a multicenter sample of infants younger than 3 months with bacteremic UTI, defined as the same pathogenic organism in blood and urine. Infants were excluded if they had any major comorbidities, known urologic abnormalities at time of presentation, required intensive unit care, or had no imaging performed. Imaging results as stated in the radiology reports were categorized by a pediatric urologist.RESULTS: Of the 276 infants, 19 were excluded. Of the remaining 257 infants, 254 underwent a RUS and 224 underwent a VCUG. Fifty-five percent had ≥1 RUS abnormalities. Thirty-four percent had ≥1 VCUG abnormalities, including vesicoureteral reflux (VUR, 27%), duplication (1.3%), and infravesicular abnormality (0.9%). Age <1 month, male sex, and non-Escherichia coli organism predicted an abnormal RUS, but only non-E coli organism predicted an abnormal VCUG. Seventeen of 96 infants (17.7%) with a normal RUS had an abnormal VCUG: 15 with VUR (Grade I-III = 13, Grade IV = 2), 2 with elevated postvoid residual, and 1 with infravesical abnormality.CONCLUSIONS: Although RUS and VCUG abnormalities were common in this cohort, the frequency and severity were similar to previous studies of infants with UTIs in general. Our findings do not support special consideration of bacteremia in imaging decisions for otherwise well-appearing young infants with UTI.

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JO - Hospital pediatrics

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