Abstract

BARROS, Ana Cristina et al. Urinary tract infection in children: 5 years of clinical and microbiological data. Arq Med [online]. 2010, vol.24, n.6, pp.247-252. ISSN 2183-2447.

Introduction: A quick diagnosis and management of urinary tract infections in children are essential to prevent future complications. Objectives: characterize children with acute pyelonephritis (APN); evaluate the therapeutic management and the imaging approach in the actual scientific evidence. Methods: Descriptive and retrospective study through consultation of the children’s clinical data with APN diagnosis in Hospital Pedro Hispano. Data was gathered concerning demographic data, urine collection method, bacterial agents and their susceptibility to antibiotics, treatment and imaging study. Results: We reviewed 348 cases of APN, whose etiologic agent was Escherichia coli in 77.6% of them. The global sensibility to amoxicillin/clavulanic acid was 78.3%. The most frequent imagiologic anomaly was vesico-ureteral reflux (VUR) in 23.2%, followed by ecografic anomalies in 20.2% and renal scars in 13.3% of children without known nephro-urologic pathology. Conclusions: Escherichia coli was the most frequent APN’s agent in children, with the empiric antibiotic therapy being determined by their sensibility. The clinical evolution with amoxicillin/clavulanic acid was good in this sample. The urine collection by catheterization reduces the contaminant agents. in face of the prevalence of nephro-urologic pathology found, it is important have guidelines for imaging evaluation after the first APN. The renal ultrasonography showed to be unnecessary in the acute phase of the pyelonephritis, but remains an important exam in the follow up. The absence of ureteral dilation in renal ultrasonography excluded significantly VUR in moderate/severe degree. The VUR presence does not necessarily mean renal lesion.

Keywords : acute pyelonephritis; renal ultrasonography; VCUG; DMSA.

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