Urology · 2025
Predictive Factors of Symptomatic UTIs in a Large Cohort of Pediatric Patients Undergoing Voiding Cystourethrogram.
СтатьяНазвание и аннотация: Перевод в очереди
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Nguyen Catherine, Broadwell Nora H, Paz Alisha, Applewhite James, Boyne Aidan, Yu Benjamin, Lee Albert
Аннотация
OBJECTIVE: To analyze the rate of positive urine cultures at the time of voiding cystourethrogram (VCUG) catheter placement and to identify clinical and demographic risk factors associated with the development of post-VCUG symptomatic infection.
METHODS: All outpatient VCUG studies with routine urine cultures obtained at the time of catheter placement at a high volume tertiary pediatric care center were retrospectively reviewed from 1/2017 to 12/2022. Demographic data, comorbidities, imaging data, urinalysis (if available), urine culture, and 14-day complications were recorded including lower urinary tract symptoms (LUTS), hospitalization, and fever.
RESULTS: A total of 1705 cases were included with a median age of 4.9. Comorbidities included spina bifida (23.0%), VUR (39.6%), recurrent UTI (46.6%), abnormal ultrasound (40.6%), and the use of prophylactic antibiotics (33.9%). Urine culture was positive in 25% of the cohort, with 4.6% having a symptomatic UTI- LUTS was present in 3.8%, hospitalization secondary to UTI occurred in 0.8%, and 1.6% exhibited post-procedural fever. In those with a positive urine culture, 41.7% were prescribed antibiotics. Age, recurrent UTI and previous ureteral surgery were the only factors associated with symptomatic UTI.
CONCLUSION: Rates of positive urine culture was 25% at the time of VCUG studies, while the rate of symptomatic UTI was only 4.6%. Of those with positive urine cultures, nearly half received antibiotics. Our findings suggest that only select patients with risk factors would benefit from a urine culture at the time of VCUG, which would avoid over-testing and over-treatment of asymptomatic bacteriuria.
METHODS: All outpatient VCUG studies with routine urine cultures obtained at the time of catheter placement at a high volume tertiary pediatric care center were retrospectively reviewed from 1/2017 to 12/2022. Demographic data, comorbidities, imaging data, urinalysis (if available), urine culture, and 14-day complications were recorded including lower urinary tract symptoms (LUTS), hospitalization, and fever.
RESULTS: A total of 1705 cases were included with a median age of 4.9. Comorbidities included spina bifida (23.0%), VUR (39.6%), recurrent UTI (46.6%), abnormal ultrasound (40.6%), and the use of prophylactic antibiotics (33.9%). Urine culture was positive in 25% of the cohort, with 4.6% having a symptomatic UTI- LUTS was present in 3.8%, hospitalization secondary to UTI occurred in 0.8%, and 1.6% exhibited post-procedural fever. In those with a positive urine culture, 41.7% were prescribed antibiotics. Age, recurrent UTI and previous ureteral surgery were the only factors associated with symptomatic UTI.
CONCLUSION: Rates of positive urine culture was 25% at the time of VCUG studies, while the rate of symptomatic UTI was only 4.6%. Of those with positive urine cultures, nearly half received antibiotics. Our findings suggest that only select patients with risk factors would benefit from a urine culture at the time of VCUG, which would avoid over-testing and over-treatment of asymptomatic bacteriuria.