Risk factors for febrile urinary tract infection in boys with posterior urethral valves

Luke Harper*, Nathalie Botto, Matthieu Peycelon, Jean Luc Michel, Marc David Leclair, Sarah Garnier, Pauline Clermidi, Alexis P. Arnaud, Anne Laure Dariel, Eric Dobremez, Alice Faure, Laurent Fourcade, Nadia Boudaoud, Yann Chaussy, Fideline Collin, Laetitia Huiart, Cyril Ferdynus, Valery Bocquet, Frederique Sauvat

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: Boys with posterior urethral valves (PUV) present an increased risk of febrile urinary tract infection (fUTI). Identifying specific risk factors could allow for tailoring UTI prevention. The aim of this study was to use the data from the CIRCUP randomized controlled trial data to identify patient characteristics associated with a higher risk of fUTI. Patients and methods: We performed a secondary analysis of the data from the CIRCUP randomized trial which included boys with PUV, randomized to circumcision and antibiotic prophylaxis vs. antibiotic prophylaxis alone and followed for 2 years. There was only 1 episode of fUTI in the circumcision group vs. 17 in the uncircumcised group. We therefore only studied the antibiotic prophylaxis alone group and compared age at prenatal diagnosis, size and weight at birth, presence of dilating VUR at diagnosis, abnormal DMSA scan at 2 months, and nadir creatinine between children who presented a fUTI and those who did not, as well as age at first episode of fUTI. Results: The study group consisted of 42 patients of which 17 presented at least on fUTI. Presence of dilating VUR was significantly associated with risk of fUTI (p = 0.03), OR: 6 [CI 95% = (1.13–27.52)]. None of the other parameters were associated with increased risk of fUTI. We observed three distinct time periods for presenting a fUTI with a decrease in infection rate after the first 40 days of life, then at 240 days of life. Conclusion: In boys with PUV, presence of high-grade VUR is associated with a higher risk of presenting a fUTI. The rate of febrile UTIs seems to decrease after 9 months.

Original languageEnglish
Article number971662
JournalFrontiers in Pediatrics
Volume10
DOIs
Publication statusPublished - 14 Sep 2022
Externally publishedYes

Keywords

  • infection
  • posterior urethral valves
  • reflux
  • risk factors
  • urinary tract abnormalities

Fingerprint

Dive into the research topics of 'Risk factors for febrile urinary tract infection in boys with posterior urethral valves'. Together they form a unique fingerprint.

Cite this