Abstract: SA-PO611
Dose Vesicoureteral Reflux Increase Risk for Bacteremia in Urinary Tract Infection?
Session Information
- Pediatric Nephrology - II
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Kim, Dabin, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
- Choi, Naye, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
- Min, Jeesu, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
- Kang, Hee Gyung, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
- Ahn, Yo Han, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
Background
Urinary tract infection (UTI) is one of the most common serious bacterial infections in children. During UTI episodes, concurrent bacteremia occurs in 5% to 31% of the cases. UTI accompanied by bacteremia is associated with adverse outcomes such as prolonged admission, shock, bacterial meningitis, and intensive-care unit admission. While it is known that bacteremic UTI had higher CRP, risk factors of concurrent bacteremia is not well investigated yet.
Vesicoureteral reflux (VUR) is commonly found in children with UTI. While it is known that bacteremic UTI had higher CRP, DNI, and creatinine level, risk factors of concurrent bacteremia is not well investigated yet.
Methods
We reviewed clinical findings of UTI cases from January 2000 to December 2021 in Seoul National University Children’s Hospital. To investigate if VUR is a risk factor for bacteremia, the study population was defined as those who had UTIs younger than 24 months and in whom voiding cystourethrogram (VCUG) was performed at the time of UTI. Urine culture, blood culture, and VCUG results were collected in addition to demographic findings. Only when blood culture reported the same pathogens as urine culture, the UTI episodes were consideredas concurrent bacteremia.
Results
Among a total of 152 (male 78.3%, female 21.7%) cases who had UTI and VCUG tests, 19 patients (12.5%) had concurrent bacteremia during febrile UTI episodes. When comparing these patients with those without concurrent bactermia (n=133), demographic findings were not statistically different, but the prevalence of high-grade VUR (VUR of grade 3 or higher) was higher in the bacteremia group (47.4%, 9/19) than in the non-bactermia group (20.3%, 27/133, P=0.018). Patients who have VUR grade 3 or higher had a 3.53-fold increased risk for bacteremia. (95% CI: 1.307-9.554)
Conclusion
Children with a VUR of grade 3 or higher are more susceptible to bacteremic UTI. Therefore, concurrent bacteremia might imply the presence of high-grade VUR. On the other hand, managing VUR might reduce the risk of bacteremia in case of UTI.