Comparison of acute lobar nephronia and uncomplicated urinary tract infection in children
Abstract
BACKGROUND/PURPOSE: This aim of this study was to assess the clinical manifestations, the microorganisms involved and their antibiotic resistance in children hospitalized due to acute lobar nephronia (ALN) and non-ALN community-acquired urinary tract infections (UTIs).
METHODS: We retrospectively reviewed the records of 265 previously healthy children hospitalized due to a first-episode of community-acquired febrile UTI between July 2004 and June 2007. Based on the results of renal ultrasonography and computed tomography, they were divided into ALN and non-ALN groups. Their demographic and clinical characteristics, distribution of microorganisms, and their antimicrobial resistance were analyzed.
RESULTS: Of the total number of cases of children admitted with a first-episode community-acquired UTI, 19.2% (n=51) were diagnosed as ALN. Children with ALN were older (1.86 years vs. 0.81 years; p < 0.01), had longer periods of fever before admission (4.7 days vs. 1.4 days; p < 0.01), higher peak body temperatures (39.5°C vs. 38.9°C; p < 0.01), higher white cell counts (18.86 × 10(9)/L vs. 15.08 × 10(9)/L; p < 0.01) and higher C-reactive protein levels (9.0 mg/dL vs. 3.5 mg/dL; p < 0.01) compared with non-ALN children. Fever also persisted for longer after the start of antibiotic treatment in the ALN children (2.7 days vs. 1.4 days: p < 0.01) and they required longer hospital stays and incurred higher medical costs. The major pathogen found in ALN was E. coli (90%). The E. coli…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 265 participants or records.
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