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REVIEW ARTICLE
Year : 2022  |  Volume : 7  |  Issue : 1  |  Page : 19-28

A contemporary overview of urinary tract infection (UTI) in children


Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh

Correspondence Address:
Prof. Ranjit R Roy
Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/pnjb.pnjb_10_22

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Urinary tract infection (UTI) is the most common and serious bacterial infection in the pediatric age group. It is more prevalent in girls than in boys, except in early infancy. Escherichia coli is responsible for 80–90% of cases of pediatric UTI. The occurrence and severity of this illness are largely mediated by bacterial virulence factors and host defense mechanism. The clinical manifestations of UTI in children are highly heterogeneous, and non-specific collection of urine sample to diagnose the condition accurately is quiet challenging for young pre-continent children. Till date, urine culture is the gold standard for diagnosing UTI. Selection of appropriate antibiotic for the treatment of UTI must be guided by the local guideline and current sensitivity pattern. Ideal imaging protocol and use of antibiotic prophylaxis are still a matter of debate. Current trend is less use of antibiotic prophylaxis due to increasing antibiotic resistance. Prophylaxis cannot alter the long-term consequences, like renal scarring in selected patients. The debate on the indication and duration of antibiotic prophylaxis is still ongoing. So, this review aimed to provide a contemporary overview on the pathogenesis, clinical findings, diagnosis, imaging investigation, treatment, complications, and preventive measures of UTI including chemoprophylaxis in pediatric population. It also highlights the conflicting recommendations of international guidelines, which reveal the necessity of further research to establish the tailored approach of pediatric UTI.


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