Urinary Tract Infection and Predisposing Factors in Children

Objective: This study was designed to determine the predisposing factors in children withsymptomatic urinary tract infection (UTI) according to age and gender.Material Methods: We reviewed prospectively 183 pediatric patients with symptomatic UTIadmitted to emergency department or referred to nephrology clinic from November 2002 throughJuly 2005. All patients underwent renal ultrasonography and voiding-cystouretherography orradionuclide cystography. Diuretic renal scan or intravenous pyelography (IVP) was performed inthose with urinary system dilatation. Urodynamic studies were done in patients with normalradiologic findings and recurrent infections or urinary-intestinal symptoms.Findings: Of 183 patients, 130 cases (71%) were female and 53 patients (29%) male. Most of thepatients (61.9%) were between 2-24 months old (P=0/001). Vesicoureteral reflux (VUR) was themost common predisposing factor in both genders (46.9% in girls and 48.9% in boys). Voidingdysfunction in girls and urinary obstruction in boys were found with a significant difference (P=0/03for both). In all age groups, except patients≤1 month, the most common predisposing factor wasreflux. Reflux, urinary obstruction and nephrolithiasis were found with a significant difference in 2-24 months age group (P=0/001 for all).Conclusion: In our study vesicoureteral reflux (VUR) was as common in boys as in girls, andsuggested urolithiasis as a significant UTI predisposing factor. This study showed that voidingdysfunction in girls and urinary obstruction in boys are as significant predisposing factors. Wesuggest urodynamic studies in patients with normal radiologic findings and recurrent infections orurinary-intestinal symptoms.