Childhood Recurrent Urinary Tract Infection in Southern Thailand

• Published in: Renal failure Vol. 35; no. 1; pp. 66 - 71
• Main Authors: Vachvanichsanong, Prayong, Dissaneewate, Pornsak, McNeil, Edward
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.01.2013; Taylor & Francis
• Subjects: Adolescent; Age Distribution; Child; Child, Preschool; Female; Follow-Up Studies; genitourinary system anomalies; Humans; Infant; Infant, Newborn; Male; Prevalence; Recurrence; Sex Distribution; Thailand - epidemiology; Time Factors; urinary tract infection; Urinary Tract Infections - epidemiology; vesicoureteral reflux; Thailand
• ISSN: 0886-022X; 1525-6049
• DOI: 10.3109/0886022X.2012.741647

Introduction: Recurrent urinary tract infection (UTI) is one of the major health problems in children because of its high rate of occurrence. Objective: Our aim of the study was to evaluate the prevalence and determine risk factors of recurrent UTI in Thai children. Patients and Methods: The medical records of children aged less than 15 years diagnosed with UTI at the Department of Pediatrics, Songklanagarind Hospital were reviewed. Results: A total of 307 children (144 boys, 163 girls) were followed up for at least 1 year. Fifty-six children, 31 (19.0%) boys and 25 (17.4%) girls, developed at least one recurrence totaling 153 recurrent UTI episodes. The recurrence rate was not statistically different between the sexes (p = 0.8). On multivariate analysis, genitourinary system (GU) anomalies, particularly vesicoureteral reflux (VUR), were the most significant risk factors. Children aged greater than 5 years had a slightly higher risk of recurrence, irrespective of gender. Comparison of organisms associated with recurrent UTI with those associated with first UTI showed that the prevalence of Escherichia coli decreased from 76.9% to 56.2% but was still the major causative agent. In contrast, the prevalence of Klebsiella pneumoniae and unusual or mixed organisms significantly increased from 7.8% to 15.0% and 6.2% to 16.3%, respectively. Conclusion: One-fifth of children who had UTI developed recurrence and the rates were similar for males and females. Independent risk factors for recurrent UTI were found to be at age of >5 years and underlying disease of either GU anomaly or VUR.