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Low bacterial count urinary tract infections in infants and young children

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Abstract

The purpose of the study was to compare bacterial species, clinical, laboratory and imaging findings (99m Tc-dimercaptosuccinic acid renal scan and voiding cystogram) in infants and children with high (≥105 colony forming units (CFU)/ml, group A patients) and low (≤5×104 CFU/ml, group C patients) bacterial count in urine cultures during first episode of urinary tract infection. Group B included patients with intermediate CFU/ml. Included were 419 symptomatic patients with: (a) no previous antibiotic treatment, (b) urine samples for quantitative cultures taken by bladder catheterisation or suprapubic bladder aspiration, (c) growth of only one microorganism, and (d) age ≤54 months (age of the oldest patient of group C). Out of 419 cultures, Escherichia coli grew in 315 (75.2%), gram-negative bacteria except E. coli in 91 (21.7%) and gram-positive in 13 (3.1%). Group C patients were significantly ( P <0.0001) more often affected with gram-negative pathogens except E. coli than group A patients (21/44 versus 67/360). Most of group C patients were younger than 24 months of age; none was older than 54 months. Comparison of the prevalence of clinical and laboratory (leucocyte count, CRP, ESR) findings between groups A and C showed no significant differences. There was no statistically significant difference in the prevalence of pyelonephritis, reflux and urological malformations (except reflux) between groups A and C. Conclusion: Low bacterial count urinary tract infections mainly affect infants and young children and are often due to gram-negative bacteria other than E. coli. Clinical and laboratory findings, prevalence of pyelonephritis, reflux and urological malformations are similar in high and low bacterial count urinary tract infections.

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Abbreviations

CFU :

colony forming units

HPF :

high-power field

SPA :

suprapubic bladder aspiration

99m Tc-DMSA :

99m Tc-dimercaptosuccinic acid

UTI :

urinary tract infection

VCUG :

voiding cystourethrography

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Authors and Affiliations

  1. Department of Paediatrics, School of Medicine, University of Patras, 265 04 , Patras, Greece

    Theodoros A. Kanellopoulos, Marinos Kantzis, Aikaterini Ellina & Dimitris A. Papanastasiou

  2. Department of Microbiology, School of Medicine, University of Patras, Patras, Greece

    Fevronia Kolonitsiou

  3. Laboratory of Nuclear Medicine, School of Medicine, University of Patras, Patras, Greece

    Paul J. Vassilakos

Authors
  1. Theodoros A. Kanellopoulos
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  2. Paul J. Vassilakos
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  3. Marinos Kantzis
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  4. Aikaterini Ellina
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  5. Fevronia Kolonitsiou
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  6. Dimitris A. Papanastasiou
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Correspondence to Dimitris A. Papanastasiou.

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Kanellopoulos, T.A., Vassilakos, P.J., Kantzis, M. et al. Low bacterial count urinary tract infections in infants and young children. Eur J Pediatr 164, 355–361 (2005). https://doi.org/10.1007/s00431-005-1632-0

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  • DOI: https://doi.org/10.1007/s00431-005-1632-0

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