Pediatric UTI Flashcards
what is the most common pathogen responsible for UTIs?
e. coli
if you find any other pathogen besides e. coli in a UTI, what complication would you be worried about?
renal scarring
renal scarring causes what symptoms?
- HTN
- proteinuria
- renal failure
what is the gold standard test for UTI?
urine culture
who gets hospitalized for UTIs?**
- under 2 months
- urosepsis (toxic appearance, hypotension, poor cap refill)
- immunocompromised patients
- vomiting or cannot tolerate oral meds
- lack of outpatient follow up
- failure of outpatient therapy
when do UTIs present in neonates?
2nd or 3rd week in term infants
incidence of UTI is how many times more likely in uncircumcised males than in circumcised males?
10x
what is the most reliable method of urine culture for uncircumcised males?
suprapubic aspiration
what are the main pathogens involved in UTIs for PRETERM infants? what is the mechanism of spread?
- coagulase negative staph
- klebsiella
- hematogenous (vs aschending)
what tests do you order for a neonate with a fever and a suspected UTI? what is the treatment?
- urine and blood cultures
- LP (if ill appearing)
- renal US (rule out abnormalities)
- VCUG if US is abnormal
- treatment: IV ampicillin and gentamycin 10-14 days
what are the first line agents for pediatric UTIs (not neonates)?
- 3rd gen ceph
- aminoglycosides
- add amoxicillin if enterococcus suspected
what do you rule out for a recurrent UTI?
- VUR
- BBD
risk for VUR is how many times more likely in whites than blacks? boys vs girls? age?
- 3x more likely in whites vs blacks
- 2x more likely in girls
- age: more likely under 2y
definition: VUR
vesicoureteral reflux: retrograde passage of urine from bladder into upper urinary tract
what is that cause of VUR?
- incompetent closure of the ureterovesical junction
- shortening of the intravesicular ureter
