Skip to main content

Diagnosis and Management of Urinary Tract Infections

  • Chapter
  • First Online:
Pediatric Kidney Disease
  • 2698 Accesses

Abstract

This chapter addresses all aspects of urinary tract infections, encompassing the initial clinical presentation, diagnosis, investigation and management. Additional sections discuss the pathophysiology and potential for renal parenchymal damage, investigative options, associated abnormalities of the kidneys and urinary tract, strategies to reduce subsequent infections and long term clinical consequences. There is an emphasis on recent research, particularly prospective randomized controlled trials that are contributing to a reassessment of appropriate investigative protocols, the acute and ongoing management, as well as an improved understanding of these common childhood infections. Shortcomings in our knowledge and directions for future research are also discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hellstrom A, Hanson E, Hansson S, Hjalmas K, Jodal U. Association between urinary symptoms at 7 years old and previous urinary tract infection. Arch Dis Child. 1991;66(2):232–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Bailey RR. The relationship of vesico-ureteric reflux to urinary tract infection and chronic pyelonephritis-reflux nephropathy. Clin Nephrol. 1973;1(3):132–41.

    CAS  PubMed  Google Scholar 

  3. Boccon-Gibod L, Galian P, Boccon-Gibod L. Renal atrophy due to reflux. Myth or realities. 12 cases. Nouv Presse Med. 1972;1(8):507–10.

    CAS  PubMed  Google Scholar 

  4. Prospective trial of operative versus non-operative treatment of severe vesicoureteric reflux: two years’ observation in 96 children. Br Med J. 1983;287(6386):171–4.

    Google Scholar 

  5. Medical versus surgical treatment of primary vesicoureteral reflux: report of the International Reflux Study Committee. Pediatrics. 1981;67(3):392–400.

    Google Scholar 

  6. Montini G, Tullus K, Hewitt I. Febrile urinary tract infections in children. N Engl J Med. 2011;365(3):239–50.

    Article  CAS  PubMed  Google Scholar 

  7. Subcommittee on Urinary Tract Infection SCoQI, Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128(3):595–610.

    Article  Google Scholar 

  8. Herreros Fernandez ML, Gonzalez Merino N, Tagarro Garcia A, Perez Seoane B, de la Serna Martinez M, Contreras Abad MT, et al. A new technique for fast and safe collection of urine in newborns. Arch Dis Child. 2013;98(1):27–9.

    Article  PubMed  Google Scholar 

  9. Al-Orifi F, McGillivray D, Tange S, Kramer MS. Urine culture from bag specimens in young children: are the risks too high? J Pediatr. 2000;137(2):221–6.

    Article  CAS  PubMed  Google Scholar 

  10. Kennedy KM, Glynn LG, Dineen B. A survey of the management of urinary tract infection in children in primary care and comparison with the NICE guidelines. BMC Fam Pract. 2010;11:6.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Leroy S, Fernandez-Lopez A, Nikfar R, Romanello C, Bouissou F, Gervaix A, et al. Association of procalcitonin with acute pyelonephritis and renal scars in pediatric UTI. Pediatrics. 2013;131(5):870–9.

    Article  PubMed  Google Scholar 

  12. Preda I, Jodal U, Sixt R, Stokland E, Hansson S. Normal dimercaptosuccinic acid scintigraphy makes voiding cystourethrography unnecessary after urinary tract infection. J Pediatr. 2007;151(6):581–4. 4 e1.

    Article  PubMed  Google Scholar 

  13. Hansson S, Dhamey M, Sigstrom O, Sixt R, Stokland E, Wennerstrom M, et al. Dimercapto-succinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infection. J Urol. 2004;172(3):1071–3; discussion 3–4.

    Article  PubMed  Google Scholar 

  14. Cox CE, Hinman Jr F. Experiments with induced bacteriuria, vesical emptying and bacterial growth on the mechanism of bladder defense to infection. J Urol. 1961;86:739–48.

    CAS  PubMed  Google Scholar 

  15. van Gool JD, Hjalmas K, Tamminen-Mobius T, Olbing H. Historical clues to the complex of dysfunctional voiding, urinary tract infection and vesicoureteral reflux. The International Reflux Study in Children. J Urol. 1992;148(5 Pt 2):1699–702.

    PubMed  Google Scholar 

  16. Sillen U, Brandstrom P, Jodal U, Holmdahl G, Sandin A, Sjoberg I, et al. The Swedish reflux trial in children: v. Bladder dysfunction. J Urol. 2010;184(1):298–304.

    Article  PubMed  Google Scholar 

  17. Ramamurthy HR, Kanitkar M. Recurrent urinary tract infection and functional voiding disorders. Indian Pediatr. 2008;45(8):689–91.

    PubMed  Google Scholar 

  18. Sideras P, Smith CI. Molecular and cellular aspects of X-linked agammaglobulinemia. Adv Immunol. 1995;59:135–223.

    Article  CAS  PubMed  Google Scholar 

  19. Forbes GS, Hartman GW, Burke EC, Segura JW. Genitourinary involvement in chronic granulomatous disease of childhood. AJR Am J Roentgenol. 1976;127(4):683–6.

    Article  CAS  PubMed  Google Scholar 

  20. Nijmegen breakage syndrome. The International Nijmegen Breakage Syndrome Study Group. Arch Dis Child. 2000;82(5):400–6.

    Google Scholar 

  21. Javor J, Bucova M, Cervenova O, Kralinsky K, Sadova E, Suchankova M, et al. Genetic variations of interleukin-8, CXCR1 and CXCR2 genes and risk of acute pyelonephritis in children. Int J Immunogenet. 2012;39(4):338–45.

    Article  CAS  PubMed  Google Scholar 

  22. Sheu JN, Chen SM, Meng MH, Lue KH. The role of serum and urine interleukin-8 on acute pyelonephritis and subsequent renal scarring in children. Pediatr Infect Dis J. 2009;28(10):885–90.

    Article  PubMed  Google Scholar 

  23. Zaffanello M, Tardivo S, Cataldi L, Fanos V, Biban P, Malerba G. Genetic susceptibility to renal scar formation after urinary tract infection: a systematic review and meta-analysis of candidate gene polymorphisms. Pediatr Nephrol. 2011;26(7):1017–29.

    Article  PubMed  Google Scholar 

  24. Tramma D, Hatzistylianou M, Gerasimou G, Lafazanis V. Interleukin-6 and interleukin-8 levels in the urine of children with renal scarring. Pediatr Nephrol. 2012;27(9):1525–30.

    Article  PubMed  Google Scholar 

  25. Hussein A, Askar E, Elsaeid M, Schaefer F. Functional polymorphisms in transforming growth factor-beta-1 (TGFbeta-1) and vascular endothelial growth factor (VEGF) genes modify risk of renal parenchymal scarring following childhood urinary tract infection. Nephrol Dial Transplant: Off Publ Eur Dial Transplant Assoc Eur Ren Assoc. 2010;25(3):779–85.

    Article  CAS  Google Scholar 

  26. Faust WC, Diaz M, Pohl HG. Incidence of post-pyelonephritic renal scarring: a meta-analysis of the dimercapto-succinic acid literature. J Urol. 2009;181(1):290–7; discussion 7–8.

    Article  PubMed  Google Scholar 

  27. Huang YY, Chen MJ, Chiu NT, Chou HH, Lin KY, Chiou YY. Adjunctive oral methylprednisolone in pediatric acute pyelonephritis alleviates renal scarring. Pediatrics. 2011;128(3):e496–504.

    PubMed  Google Scholar 

  28. Sobouti B, Hooman N, Movahed M. The effect of vitamin E or vitamin A on the prevention of renal scarring in children with acute pyelonephritis. Pediatr Nephrol. 2013;28(2):277–83.

    Article  PubMed  Google Scholar 

  29. Tugtepe H, Sener G, Cetinel S, Velioglu-Ogunc A, Yegen BC. Oxidative renal damage in pyelonephritic rats is ameliorated by montelukast, a selective leukotriene CysLT1 receptor antagonist. Eur J Pharmacol. 2007;557(1):69–75.

    Article  CAS  PubMed  Google Scholar 

  30. Gurocak S, Ure I, Cumaoglu A, Gonul II, Sen I, Tan O, et al. Renal tissue damage after experimental pyelonephritis: role of antioxidants and selective cyclooxygenase-2 inhibitors. Urology. 2010;76(2):508 e1–5.

    Article  Google Scholar 

  31. Imamoglu M, Cay A, Cobanoglu U, Bahat E, Karahan C, Tosun I, et al. Effects of melatonin on suppression of renal scarring in experimental model of pyelonephritis. Urology. 2006;67(6):1315–9.

    Article  PubMed  Google Scholar 

  32. Khalil A, Tullus K, Bakhiet M, Burman LG, Jaremko G, Brauner A. Angiotensin II type 1 receptor antagonist (losartan) down-regulates transforming growth factor-beta in experimental acute pyelonephritis. J Urol. 2000;164(1):186–91.

    Article  CAS  PubMed  Google Scholar 

  33. Tullus K, Jacobson SH, Katouli M, Brauner A. Relative importance of eight virulence characteristics of pyelonephritogenic Escherichia coli strains assessed by multivariate statistical analysis. J Urol. 1991;146(4):1153–5.

    CAS  PubMed  Google Scholar 

  34. Mulvey MA. Adhesion and entry of uropathogenic Escherichia coli. Cell Microbiol. 2002;4(5):257–71.

    Article  CAS  PubMed  Google Scholar 

  35. Mysorekar IU, Hultgren SJ. Mechanisms of uropathogenic Escherichia coli persistence and eradication from the urinary tract. Proc Natl Acad Sci U S A. 2006;103(38):14170–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Hussain A, Ewers C, Nandanwar N, Guenther S, Jadhav S, Wieler LH, et al. Multiresistant uropathogenic Escherichia coli from a region in India where urinary tract infections are endemic: genotypic and phenotypic characteristics of sequence type 131 isolates of the CTX-M-15 extended-spectrum-beta-lactamase-producing lineage. Antimicrob Agents Chemother. 2012;56(12):6358–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Cegelski L, Marshall GR, Eldridge GR, Hultgren SJ. The biology and future prospects of antivirulence therapies. Nat Rev Microbiol. 2008;6(1):17–27.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Trautner BW, Hull RA, Thornby JI, Darouiche RO. Coating urinary catheters with an avirulent strain of Escherichia coli as a means to establish asymptomatic colonization. Infect Control Hosp Epidemiol: Off J Soc Hosp Epidemiol Am. 2007;28(1):92–4.

    Article  Google Scholar 

  39. Montini G, Toffolo A, Zucchetta P, Dall’Amico R, Gobber D, Calderan A, et al. Antibiotic treatment for pyelonephritis in children: multicentre randomised controlled non-inferiority trial. BMJ. 2007;335(7616):386.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Neuhaus TJ, Berger C, Buechner K, Parvex P, Bischoff G, Goetschel P, et al. Randomised trial of oral versus sequential intravenous/oral cephalosporins in children with pyelonephritis. Eur J Pediatr. 2008;167(9):1037–47.

    Article  CAS  PubMed  Google Scholar 

  41. Prelog M, Schiefecker D, Fille M, Wurzner R, Brunner A, Zimmerhackl LB. Febrile urinary tract infection in children: ampicillin and trimethoprim insufficient as empirical mono-therapy. Pediatr Nephrol. 2008;23(4):597–602.

    Article  PubMed  Google Scholar 

  42. Robinson JL, Davies HD, Barton M, O’Brien K, Simpson K, Asztalos E, et al. Characteristics and outcome of infants with candiduria in neonatal intensive care – a Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study. BMC Infect Dis. 2009;9:183.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Nourse PJ, Cotton MF, Bates WD. Renal manifestations in children co-infected with HIV and disseminated tuberculosis. Pediatr Nephrol. 2010;25(9):1759–63.

    Article  PubMed  Google Scholar 

  44. Chebotareva AA, Chebotareva TV, Oblogina LI, Kosinova AM, Permiakova VM. Extrapulmonary tuberculosis in risk-group children: detection methods and clinical characteristics. Probl Tuberk Bolezn Legk. 2008;4:11–7.

    Google Scholar 

  45. MacConnachie A. Schistosomiasis. J R Coll Physicians Edinb. 2012;42(1):47–9; quiz 50.

    Article  CAS  PubMed  Google Scholar 

  46. Morgan OW, Brunette G, Kapella BK, McAuliffe I, Katongole-Mbidde E, Li W, et al. Schistosomiasis among recreational users of Upper Nile River, Uganda, 2007. Emerg Infect Dis. 2010;16(5):866–8.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Thomson J, Mc Donald S. On acute pyelitis due to bacillus coli as it occurs in infancy. QJM. 2010;3:251–68.

    Google Scholar 

  48. Fitzgerald A, Mori R, Lakhanpaul M, Tullus K. Antibiotics for treating lower urinary tract infection in children. Cochrane Database Syst Rev. 2012;(8):CD006857.

    Google Scholar 

  49. Francois P, Croize J, Bost C, Wollschlager K. Comparative study of cefixime versus amoxicillin-clavulanic acid combination in the oral treatment of urinary tract infections in children. Arch Pediatr: Organe Off Soc Fr Pediatr. 1995;2(2):136–42.

    Article  CAS  Google Scholar 

  50. Benador D, Neuhaus TJ, Papazyan JP, Willi UV, Engel-Bicik I, Nadal D, et al. Randomised controlled trial of three day versus 10 day intravenous antibiotics in acute pyelonephritis: effect on renal scarring. Arch Dis Child. 2001;84(3):241–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Levtchenko E, Lahy C, Levy J, Ham H, Piepsz A. Treatment of children with acute pyelonephritis: a prospective randomized study. Pediatr Nephrol. 2001;16(11):878–84.

    Article  CAS  PubMed  Google Scholar 

  52. Vilaichone A, Watana D, Chaiwatanarat T. Oral ceftibuten switch therapy for acute pyelonephritis in children. J Med Assoc Thail = Chotmaihet Thangphaet. 2001;84 Suppl 1:S61–7.

    Google Scholar 

  53. Noorbakhsh S, Lari AR, Masjedian F, Mostafavi H, Alaghehbandan R. Comparison of intravenous aminoglycoside therapy with switch therapy to cefixime in urinary tract infections. Saudi Med J. 2004;25(10):1513–5.

    PubMed  Google Scholar 

  54. Hoberman A, Wald ER, Hickey RW, Baskin M, Charron M, Majd M, et al. Oral versus initial intravenous therapy for urinary tract infections in young febrile children. Pediatrics. 1999;104(1 Pt 1):79–86.

    Article  CAS  PubMed  Google Scholar 

  55. Bocquet N, Sergent Alaoui A, Jais JP, Gajdos V, Guigonis V, Lacour B, et al. Randomized trial of oral versus sequential IV/oral antibiotic for acute pyelonephritis in children. Pediatrics. 2012;129(2):e269–75.

    Article  PubMed  Google Scholar 

  56. Ammenti A, Cataldi L, Chimenz R, Fanos V, La Manna A, Marra G, et al. Febrile urinary tract infections in young children: recommendations for the diagnosis, treatment and follow-up. Acta Paediatr. 2012;101(5):451–7.

    Article  PubMed  Google Scholar 

  57. Urinary tract infection in children: diagnosis, treatment and long-term management. National Institute for Health and Clinical Excellence: Guidance. London; 2007. Available from: http://www.nice.org.uk/cg54.

  58. Hogan J, Dourthe ME, Blondiaux E, Jouannic JM, Garel C, Ulinski T. Renal outcome in children with antenatal diagnosis of severe CAKUT. Pediatr Nephrol. 2012;27(3):497–502.

    Article  PubMed  Google Scholar 

  59. Hoberman A, Charron M, Hickey RW, Baskin M, Kearney DH, Wald ER. Imaging studies after a first febrile urinary tract infection in young children. N Engl J Med. 2003;348(3):195–202.

    Article  PubMed  Google Scholar 

  60. Zamir G, Sakran W, Horowitz Y, Koren A, Miron D. Urinary tract infection: is there a need for routine renal ultrasonography? Arch Dis Child. 2004;89(5):466–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Montini G, Zucchetta P, Tomasi L, Talenti E, Rigamonti W, Picco G, et al. Value of imaging studies after a first febrile urinary tract infection in young children: data from Italian renal infection study 1. Pediatrics. 2009;123(2):e239–46.

    Article  PubMed  Google Scholar 

  62. Coulthard MG. Vesicoureteric reflux is not a benign condition. Pediatr Nephrol. 2009;24(2):227–32.

    Article  PubMed  Google Scholar 

  63. Wennerstrom M, Hansson S, Jodal U, Stokland E. Primary and acquired renal scarring in boys and girls with urinary tract infection. J Pediatr. 2000;136(1):30–4.

    Article  CAS  PubMed  Google Scholar 

  64. Broyer M, Chantler C, Donckerwolcke R, Ehrich JH, Rizzoni G, Scharer K. The paediatric registry of the European Dialysis and Transplant Association: 20 years’ experience. Pediatr Nephrol. 1993;7(6):758–68.

    Article  CAS  PubMed  Google Scholar 

  65. Brandstrom P, Neveus T, Sixt R, Stokland E, Jodal U, Hansson S. The Swedish reflux trial in children: IV. Renal damage. J Urol. 2010;184(1):292–7.

    Article  PubMed  Google Scholar 

  66. Fouzas S, Krikelli E, Vassilakos P, Gkentzi D, Papanastasiou DA, Salakos C. DMSA scan for revealing vesicoureteral reflux in young children with urinary tract infection. Pediatrics. 2010;126(3):e513–9.

    Article  PubMed  Google Scholar 

  67. Marks SD, Gordon I, Tullus K. Imaging in childhood urinary tract infections: time to reduce investigations. Pediatr Nephrol. 2008;23(1):9–17.

    Article  PubMed  Google Scholar 

  68. Jones RA, Grattan-Smith JD, Little S. Pediatric magnetic resonance urography. J Magn Reson Imaging: JMRI. 2011;33(3):510–26.

    Article  PubMed  Google Scholar 

  69. Schroeder AR, Abidari JM, Kirpekar R, Hamilton JR, Kang YS, Tran V, et al. Impact of a more restrictive approach to urinary tract imaging after febrile urinary tract infection. Arch Pediatr Adolesc Med. 2011;165(11):1027–32.

    Article  PubMed  Google Scholar 

  70. Deader R, Tiboni SG, Malone PS, Fairhurst J. Will the implementation of the 2007 National Institute for Health and Clinical Excellence (NICE) guidelines on childhood urinary tract infection (UTI) in the UK miss significant urinary tract pathology? BJU Int. 2012;110(3):454–8.

    Article  PubMed  Google Scholar 

  71. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Pediatrics. 1999;103(4 Pt 1):843–52.

    Google Scholar 

  72. Jerardi KE, Elkeeb D, Weiser J, Brinkman WB. Rapid implementation of evidence-based guidelines for imaging after first urinary tract infection. Pediatrics. 2013;132(3):e749–55.

    Article  PubMed  PubMed Central  Google Scholar 

  73. La Scola C, De Mutiis C, Hewitt IK, Puccio G, Toffolo A, Zucchetta P, et al. Different guidelines for imaging after first UTI in febrile infants: yield, cost, and radiation. Pediatrics. 2013;131(3):e665–71.

    Article  PubMed  Google Scholar 

  74. Royal Children’s Hospital. Clinical practice guidelines. Urinary tract infection. Available from: http://www.rch.org.au/clinicalguide/guideline_index/Urinary_Tract_Infection_Guideline/.

  75. Garin EH, Olavarria F, Garcia Nieto V, Valenciano B, Campos A, Young L. Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study. Pediatrics. 2006;117(3):626–32.

    Article  PubMed  Google Scholar 

  76. Pennesi M, Travan L, Peratoner L, Bordugo A, Cattaneo A, Ronfani L, et al. Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial. Pediatrics. 2008;121(6):e1489–94.

    Article  PubMed  Google Scholar 

  77. Roussey-Kesler G, Gadjos V, Idres N, Horen B, Ichay L, Leclair MD, et al. Antibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflux: results from a prospective randomized study. J Urol. 2008;179(2):674–9; discussion 9.

    Article  CAS  PubMed  Google Scholar 

  78. Montini G, Rigon L, Zucchetta P, Fregonese F, Toffolo A, Gobber D, et al. Prophylaxis after first febrile urinary tract infection in children? A multicenter, randomized, controlled, noninferiority trial. Pediatrics. 2008;122(5):1064–71.

    Article  PubMed  Google Scholar 

  79. Craig JC, Simpson JM, Williams GJ, Lowe A, Reynolds GJ, McTaggart SJ, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med. 2009;361(18):1748–59.

    Article  CAS  PubMed  Google Scholar 

  80. Brandstrom P, Esbjorner E, Herthelius M, Swerkersson S, Jodal U, Hansson S. The Swedish reflux trial in children: III. Urinary tract infection pattern. J Urol. 2010;184(1):286–91.

    Article  PubMed  Google Scholar 

  81. RIVUR Trial Investigators, Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, et al. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 2014;370(25):2367–76.

    Google Scholar 

  82. Williams G, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev. 2011(3):CD001534.

    Google Scholar 

  83. Clarke SA, Samuel M, Boddy SA. Are prophylactic antibiotics necessary with clean intermittent catheterization? A randomized controlled trial. J Pediatr Surg. 2005;40(3):568–71.

    Article  PubMed  Google Scholar 

  84. Morton SC, Shekelle PG, Adams JL, Bennett C, Dobkin BH, Montgomerie J, et al. Antimicrobial prophylaxis for urinary tract infection in persons with spinal cord dysfunction. Arch Phys Med Rehabil. 2002;83(1):129–38.

    Article  PubMed  Google Scholar 

  85. Schlager TA, Johnson JR, Ouellette LM, Whittam TS. Escherichia coli colonizing the neurogenic bladder are similar to widespread clones causing disease in patients with normal bladder function. Spinal Cord. 2008;46(9):633–8.

    Article  CAS  PubMed  Google Scholar 

  86. Gonzalez Celedon C, Bitsori M, Tullus K. Progression of chronic renal failure in children with dysplastic kidneys. Pediatr Nephrol. 2007;22(7):1014–20.

    Article  PubMed  Google Scholar 

  87. American Urological Association. Clinical guidelines.Vesicoureteral reflux. Available from: http://www.auanet.org/education/guidelines/vesicoureteral-reflux-a.cfm.

  88. Jagannath VA, Fedorowicz Z, Sud V, Verma AK, Hajebrahimi S. Routine neonatal circumcision for the prevention of urinary tract infections in infancy. Cochrane Database Syst Rev. 2012;(11):CD009129.

    Google Scholar 

  89. Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies. Arch Dis Child. 2005;90(8):853–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Morris BJ, Wiswell TE. Circumcision and lifetime risk of urinary tract infection: a systematic review and meta-analysis. J Urol. 2013;189(6):2118–24.

    Article  PubMed  Google Scholar 

  91. Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2012;(10):CD001321.

    Google Scholar 

  92. Stapleton AE, Au-Yeung M, Hooton TM, Fredricks DN, Roberts PL, Czaja CA, et al. Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection. Clin Infect Dis: Off Publ Infect Dis Soc Am. 2011;52(10):1212–7.

    Article  Google Scholar 

  93. Kumar S, Bansal A, Chakrabarti A, Singhi S. Evaluation of efficacy of probiotics in prevention of candida colonization in a PICU-a randomized controlled trial. Crit Care Med. 2013;41(2):565–72.

    Article  PubMed  Google Scholar 

  94. Shaikh N, Ewing AL, Bhatnagar S, Hoberman A. Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 2010;126(6):​1084–91.

    Article  PubMed  Google Scholar 

  95. Hewitt IK, Zucchetta P, Rigon L, Maschio F, Molinari PP, Tomasi L, et al. Early treatment of acute pyelonephritis in children fails to reduce renal scarring: data from the Italian Renal Infection Study Trials. Pediatrics. 2008;122(3):486–90.

    Article  PubMed  Google Scholar 

  96. Toffolo A, Ammenti A, Montini G. Long-term clinical consequences of urinary tract infections during childhood: a review. Acta Paediatr. 2012;101(10):1018–31.

    Article  PubMed  Google Scholar 

  97. Jansen H, Scholtmeijer RJ. Results of surgical treatment of severe vesicoureteric reflux. Retrospective study of reflux grades 4 and 5. Br J Urol. 1990;65(4):413–7.

    Article  CAS  PubMed  Google Scholar 

  98. Weiss R, Duckett J, Spitzer A. Results of a randomized clinical trial of medical versus surgical management of infants and children with grades III and IV primary vesicoureteral reflux (United States). The International Reflux Study in Children. J Urol. 1992;148(5 Pt 2):1667–73.

    CAS  PubMed  Google Scholar 

  99. Smellie JM, Prescod NP, Shaw PJ, Risdon RA, Bryant TN. Childhood reflux and urinary infection: a follow-up of 10–41 years in 226 adults. Pediatr Nephrol. 1998;12(9):727–36.

    Article  CAS  PubMed  Google Scholar 

  100. Smellie JM, Barratt TM, Chantler C, Gordon I, Prescod NP, Ransley PG, et al. Medical versus surgical treatment in children with severe bilateral vesicoureteric reflux and bilateral nephropathy: a randomised trial. Lancet. 2001;357(9265):1329–33.

    Article  CAS  PubMed  Google Scholar 

  101. Jodal U, Smellie JM, Lax H, Hoyer PF. Ten-year results of randomized treatment of children with severe vesicoureteral reflux. Final report of the International Reflux Study in Children. Pediatr Nephrol. 2006;21(6):785–92.

    Article  PubMed  Google Scholar 

  102. Wennerstrom M, Hansson S, Jodal U, Sixt R, Stokland E. Renal function 16 to 26 years after the first urinary tract infection in childhood. Arch Pediatr Adolesc Med. 2000;154(4):339–45.

    Article  CAS  PubMed  Google Scholar 

  103. Contopoulos-Ioannidis DG, Giotis ND, Baliatsa DV, Ioannidis JP. Extended interval aminoglycoside administration for children: a meta-analysis. Pediatrics. 2004;114(1):e111–8. Ria doluptatessi ut aut explat.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Giovanni Montini .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hewitt, I.K., Montini, G. (2016). Diagnosis and Management of Urinary Tract Infections. In: Geary, D., Schaefer, F. (eds) Pediatric Kidney Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52972-0_41

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-52972-0_41

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-52970-6

  • Online ISBN: 978-3-662-52972-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics